Provider Demographics
NPI:1871920439
Name:LIPPA, AMBER L (PA-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:L
Last Name:LIPPA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:LYNNE
Other - Last Name:MELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:150 EMORY ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2439
Mailing Address - Country:US
Mailing Address - Phone:508-222-2021
Mailing Address - Fax:508-342-1907
Practice Address - Street 1:150 EMORY ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2439
Practice Address - Country:US
Practice Address - Phone:508-222-2021
Practice Address - Fax:508-342-1907
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA4836363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant