Individual
MRS. MARY CHRISTY LIPSCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP-BC
Contact information
Practice address
1508 TOMBRAS AVE, EAST RIDGE, TN 37412-2720
(423) 867-4969
(423) 867-4971
Mailing address
1508 TOMBRAS AVE, EAST RIDGE, TN 37412-2720
(423) 867-4969
(423) 867-4971
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
17817
TN
363LA2200X
Adult Health Nurse Practitioner
17817
TN
363LG0600X
Gerontology Nurse Practitioner
17817
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6050407
BCBS OF TENNESSEE
TN
05
—
Q014366
—
TN
Enumeration date
07/27/2013
Last updated
01/06/2016
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