Provider Demographics
NPI:1063864403
Name:LAWRENCE, JENNIFER RIPPETOE (MS, ATC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:RIPPETOE
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4267 TURNBERRY RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37090-6503
Mailing Address - Country:US
Mailing Address - Phone:615-618-2718
Mailing Address - Fax:
Practice Address - Street 1:4267 TURNBERRY RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37090-6503
Practice Address - Country:US
Practice Address - Phone:615-618-2718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN284246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other