Provider Demographics
NPI:1801335591
Name:SIPES, SUSAN ELIZABETH (RN, MSN, AGPCNP-C)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:SIPES
Suffix:
Gender:F
Credentials:RN, MSN, AGPCNP-C
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Mailing Address - Street 1:29943 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1299
Mailing Address - Country:US
Mailing Address - Phone:317-706-7246
Mailing Address - Fax:317-706-3419
Practice Address - Street 1:533 E COUNTY LINE RD STE 201B
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1074
Practice Address - Country:US
Practice Address - Phone:317-706-7246
Practice Address - Fax:317-706-7246
Is Sole Proprietor?:No
Enumeration Date:2017-02-15
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71006881A363LG0600X, 363LP2300X, 363LA2200X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health