IndividualActive
Jake Lipps
NPI 1659985596 · Certified Registered Nurse Anesthetist · Ponchatoula, LA
Provider details
- NPI number
- 1659985596
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 236041 (LA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
40068 Davis Dr
Ponchatoula, LA 70454-6410
Phone: (985) 974-9687
Approximate (ZIP-level) locationGet directions
Mailing address
40068 Davis Dr
Ponchatoula, LA 70454-6410
Registry dates
- Enumerated
- 2020-09-08
- Last updated
- 2024-07-11
- Certified
- 2024-07-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.