Tippett, Jodi Lynn

Tippett, Jodi Lynn is an individual health care provider with primary practice located at 169 Elm St , Waltham MA 02453-5356. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Tippett, Jodi Lynn can be contacted via phone (781) 894-8440.

Contact Information

Primary practice address
169 Elm St Waltham MA 02453-5356
Phone: (781) 894-8440
Fax: (781) 894-1202
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 237497 Massachusetts

Profile Details

NPI number 1083797302
LBN Legal business name Tippett, Jodi Lynn
Credentials APRN BC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083797302 NPPES
Massachusetts Other 1303287 MBHP
Massachusetts MEDICAID 1303287 MBHP
Massachusetts Other M18633 MBHP

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