NPI | 1295702371 |
---|---|
Other Name | BETHANY LYNN TIPPETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9104980) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110001819) |
Enumeration Date | 2006-03-07 |
Last Update Date | 2018-03-17 |