Provider Demographics
NPI:1265934988
Name:PIPPIN, PAULA CHRISTINE
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:CHRISTINE
Last Name:PIPPIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 GEMINI DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3225
Mailing Address - Country:US
Mailing Address - Phone:817-893-8850
Mailing Address - Fax:
Practice Address - Street 1:304 GEMINI DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3225
Practice Address - Country:US
Practice Address - Phone:817-893-8850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX321644164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse