Individual
MS. MINDY J LIPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN/NP
Contact information
Practice address
5293 S ANGELA RD, MEMPHIS, TN 38120-2203
(901) 761-0422
(901) 683-8700
Mailing address
5293 S ANGELA RD, MEMPHIS, TN 38120-2203
(901) 761-0422
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
60214
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126536
—
MS
05
—
1138321
—
LA
05
—
149326758
—
AR
05
—
200390060A
—
KS
05
—
3349720
—
TN
05
—
425861101
—
MO
01
—
99423
BCBS AR
AR
05
—
QNP019
—
SC
Enumeration date
12/23/2005
Last updated
09/04/2009
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