| Doctor Name: | MRS. MARY CHRISTY LIPSCOMB |
| NPI Number: | 1790127090 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | AG-ACNP-BC |
| License Number: | 17817 |
| Business Practice Address: | 1508 Tombras Ave East Ridge, TN - 374122720 |
| Business Phone Number: | 4238674969 |
| Business Fax Number: | 4238674971 |
| Mailing Address: | 1508 Tombras Ave, EAST RIDGE |
| State: | TN |
| Postal Code: | 374122720 |
| Phone Number: | 4238674969 |
| Fax Number: | 4238674971 |
| NPI Enumeration Date: | 07/27/2013 |
| NPI Last Update Date: | 01/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | 17817 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |