Provider Demographics
NPI:1417608761
Name:TRIPP, JAIME (RN)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:TRIPP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8840 RIVER RISE DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-1628
Mailing Address - Country:US
Mailing Address - Phone:901-289-2797
Mailing Address - Fax:901-257-4441
Practice Address - Street 1:4536 WINDCHIME CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-1446
Practice Address - Country:US
Practice Address - Phone:901-289-2797
Practice Address - Fax:901-257-4441
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN197737163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse