Active NPI
Debra Sue Tippin, R.N.
- Registered Nurse
- Midland, MI
National Provider Identifier
1205273281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 4704149621
- Practice address
- 218 Fast Ice Dr
Midland, MI 48642-6167 - Phone
- (989) 631-2320
- Fax
- (989) 631-9903
- NPI assigned
- May 30, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704149621 | MI | Primary |
Addresses
Primary practice location
218 Fast Ice Dr
Midland, MI 48642-6167
Mailing address
3695 N Sadler Dr
Sanford, MI 48657-9331
Phone (517) 262-3613
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704149621 | MI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369872000000",
"number": "1205273281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3695 N SADLER DR",
"city": "SANFORD",
"state": "MI",
"postal_code": "486579331",
"telephone_number": "517-262-3613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 FAST ICE DR",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486426167",
"telephone_number": "989-631-2320",
"fax_number": "989-631-9903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIPPIN",
"first_name": "DEBRA",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-30",
"last_updated": "2013-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704149621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.