Individual
MRS. SHELBY LIPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
110 TCHULA ST, LEXINGTON, MS 39095-3111
(662) 834-1855
(662) 834-4953
Mailing address
110 TCHULA ST, LEXINGTON, MS 39095-3111
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R620688
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7989254
—
MS
01
—
P00393344
MEDICARE RAILROAD
MS
Enumeration date
08/20/2006
Last updated
08/16/2011
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