Provider Demographics
NPI:1235215179
Name:KIPPERMAN, STACY MICHELLE (APRN, RN)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:MICHELLE
Last Name:KIPPERMAN
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Gender:F
Credentials:APRN, RN
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Mailing Address - Street 1:65 CENTRAL PARK W APT 4F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6009
Mailing Address - Country:US
Mailing Address - Phone:718-515-2330
Mailing Address - Fax:718-515-2608
Practice Address - Street 1:120 CONNECTICUT AVENUE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854
Practice Address - Country:US
Practice Address - Phone:203-899-1770
Practice Address - Fax:203-899-1769
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2024-12-26
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Provider Licenses
StateLicense IDTaxonomies
NY563322363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner