Kipper, Bradi Michael Peter

Kipper, Bradi Michael Peter is an individual health care provider with primary practice located at 2300 53Rd Ave Suite 100, Bettendorf IA 52722-7564. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Kipper, Bradi Michael Peter can be contacted via phone (563) 322-0971.

Contact Information

Primary practice address
2300 53Rd Ave Suite 100 Bettendorf IA 52722-7564
Phone: (563) 322-0971
Fax: (563) 324-0615
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 002217 Iowa
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085004237 Illinois

Profile Details

NPI number 1184904567
LBN Legal business name Kipper, Bradi Michael Peter
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2011
Last updated Nov 14th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184904567 NPPES
Iowa Other 578210014 MEDICARE PTAN

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