Provider Demographics
NPI:1447440425
Name:FIPPS, JENNIFER (DC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:FIPPS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 CASSIDY BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1559
Mailing Address - Country:US
Mailing Address - Phone:859-203-5100
Mailing Address - Fax:606-393-0902
Practice Address - Street 1:274 CASSIDY BLVD STE 2
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1559
Practice Address - Country:US
Practice Address - Phone:606-653-6016
Practice Address - Fax:606-653-6017
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1702111N00000X
KY249207111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor