Provider Demographics
NPI:1902595572
Name:FLIPPEN, DANA
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:FLIPPEN
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 1:1208 LANCER LN
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-5505
Mailing Address - Country:US
Mailing Address - Phone:267-826-2054
Mailing Address - Fax:
Practice Address - Street 1:100 WEST AVE STE 910S
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2642
Practice Address - Country:US
Practice Address - Phone:215-245-2151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN697381163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse