Provider Demographics
NPI:1649047226
Name:PIPPIN, TRESSA ANN
Entity type:Individual
Prefix:
First Name:TRESSA
Middle Name:ANN
Last Name:PIPPIN
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 1:54270 TOWNSHIP ROAD 172
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:OH
Mailing Address - Zip Code:43824-9060
Mailing Address - Country:US
Mailing Address - Phone:740-227-0322
Mailing Address - Fax:
Practice Address - Street 1:54270 TOWNSHIP ROAD 172
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:OH
Practice Address - Zip Code:43824-9060
Practice Address - Country:US
Practice Address - Phone:740-227-0322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide