Provider Demographics
NPI:1861610743
Name:LIPPE, JULIENNE (MD)
Entity type:Individual
Prefix:DR
First Name:JULIENNE
Middle Name:
Last Name:LIPPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIENNE
Other - Middle Name:LIPPE
Other - Last Name:BOONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:308 LOUISIANA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:LIBBY
Mailing Address - State:MT
Mailing Address - Zip Code:59923-2159
Mailing Address - Country:US
Mailing Address - Phone:406-283-6824
Mailing Address - Fax:406-283-3022
Practice Address - Street 1:308 LOUISIANA AVE STE 2
Practice Address - Street 2:
Practice Address - City:LIBBY
Practice Address - State:MT
Practice Address - Zip Code:59923-2159
Practice Address - Country:US
Practice Address - Phone:406-283-6824
Practice Address - Fax:406-283-3022
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011016774207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine