Provider Demographics
NPI:1043965288
Name:TRIPP, ANITA MAY (BSN, RN)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:MAY
Last Name:TRIPP
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:MAY
Other - Last Name:BALLWEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12803-4801
Mailing Address - Country:US
Mailing Address - Phone:518-528-0253
Mailing Address - Fax:
Practice Address - Street 1:3043 US-4
Practice Address - Street 2:
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839
Practice Address - Country:US
Practice Address - Phone:518-747-2284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY682124163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health