| Doctor Name: | MARK SIPE |
| NPI Number: | 1003265679 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 93000 |
| Business Practice Address: | 2459 Crums Church Rd Berryville, VA - 226112019 |
| Business Phone Number: | 5409317595 |
| Business Fax Number: | |
| Mailing Address: | 2459 Crums Church Rd, BERRYVILLE |
| State: | VA |
| Postal Code: | 226112019 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/06/2016 |
| NPI Last Update Date: | 06/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | 93000 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WV |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |