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Individual

MICAELA M LIPPERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
333 STATE ST STE 104, ERIE, PA 16507-1463
(724) 933-0300
Mailing address
7000 STONEWOOD DR STE 151, WEXFORD, PA 15090-7376
(724) 933-0300

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1093733933
GROUP NPI
PA
Enumeration date
07/22/2020
Last updated
07/22/2020
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