Provider Demographics
NPI:1528942422
Name:LIPSCOMB, LANAE NICOLE
Entity type:Individual
Prefix:
First Name:LANAE
Middle Name:NICOLE
Last Name:LIPSCOMB
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 1:1325 5TH ST NE APT 402
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-8598
Mailing Address - Country:US
Mailing Address - Phone:202-352-1743
Mailing Address - Fax:
Practice Address - Street 1:3750 JAMISON ST NE APT 510
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-4472
Practice Address - Country:US
Practice Address - Phone:202-352-1743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC13661823747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant