| Doctor Name: | KIMBERLY C TIPTON |
| NPI Number: | 1922406545 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 116499 |
| Business Practice Address: | 1301 Industrial Pkwy E El Dorado Springs, MO - 647446263 |
| Business Phone Number: | 4178765700 |
| Business Fax Number: | |
| Mailing Address: | 1301 Industrial Pkwy E, EL DORADO SPRINGS |
| State: | MO |
| Postal Code: | 647446263 |
| Phone Number: | 4178765700 |
| Fax Number: | |
| NPI Enumeration Date: | 12/13/2014 |
| NPI Last Update Date: | 12/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | 116499 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |