Provider Demographics
NPI:1093920720
Name:RIPPETOE, LINDA (DIETITIAN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:RIPPETOE
Suffix:
Gender:F
Credentials:DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28071 W 88TH CIRCLE
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:KS
Mailing Address - Zip Code:66018-9258
Mailing Address - Country:US
Mailing Address - Phone:913-583-3706
Mailing Address - Fax:
Practice Address - Street 1:325 MAINE
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044
Practice Address - Country:US
Practice Address - Phone:785-840-3039
Practice Address - Fax:785-840-3041
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS940133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS130426Medicare ID - Type UnspecifiedLAWRENCE MEMORIAL HOSPITA