Provider Demographics
NPI:1881977080
Name:SCHIPPER, ABBEY MARIE (LPN)
Entity type:Individual
Prefix:MISS
First Name:ABBEY
Middle Name:MARIE
Last Name:SCHIPPER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 JOHNSON PL APT A
Mailing Address - Street 2:
Mailing Address - City:CROOKSTON
Mailing Address - State:MN
Mailing Address - Zip Code:56716-1008
Mailing Address - Country:US
Mailing Address - Phone:701-741-5223
Mailing Address - Fax:701-747-5409
Practice Address - Street 1:1599 J ST
Practice Address - Street 2:319TH MEDICAL GROUP- TOPA RM#619
Practice Address - City:GRAND FORKS AFB
Practice Address - State:ND
Practice Address - Zip Code:58205-6306
Practice Address - Country:US
Practice Address - Phone:701-747-3108
Practice Address - Fax:701-747-5409
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN067829-6164W00000X
NDL12865164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse