Provider Demographics
NPI:1134273493
Name:LIPSETT, LOISE A (ARNP)
Entity type:Individual
Prefix:
First Name:LOISE
Middle Name:A
Last Name:LIPSETT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 NW 94TH TER
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-2747
Mailing Address - Country:US
Mailing Address - Phone:954-746-2215
Mailing Address - Fax:
Practice Address - Street 1:8790 W MCNAB RD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-3214
Practice Address - Country:US
Practice Address - Phone:954-746-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL926192363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P70503Medicare UPIN
FLE8171AMedicare ID - Type Unspecified