Provider Demographics
NPI:1497636336
Name:SIPE, CONNIE KAY
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:KAY
Last Name:SIPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 E MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-2733
Mailing Address - Country:US
Mailing Address - Phone:304-741-1481
Mailing Address - Fax:
Practice Address - Street 1:86 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-2733
Practice Address - Country:US
Practice Address - Phone:304-741-1481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker