Provider Demographics
NPI:1750864625
Name:LIPPERT, ABIGAIL ELISE (ATC)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ELISE
Last Name:LIPPERT
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 DEER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-7064
Mailing Address - Country:US
Mailing Address - Phone:678-773-3320
Mailing Address - Fax:
Practice Address - Street 1:3932 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5931
Practice Address - Country:US
Practice Address - Phone:270-798-9418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer