Individual
STACEY ANN NIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
324 W SUPERIOR ST, STE 408, DULUTH, MN 55802
(218) 722-0615
(218) 722-6712
Mailing address
324 W SUPERIOR ST, STE 408, DULUTH, MN 55802
(218) 722-0615
(218) 722-6712
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
482
MN
213ES0103X
Foot & Ankle Surgery Podiatrist
482
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014725700
—
MN
01
—
5B969N0
BCBS
—
Enumeration date
04/06/2006
Last updated
05/09/2012
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