Provider Demographics
NPI:1437703303
Name:CRIPPIN, AUDREY LAUREL (PHARMD)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:LAUREL
Last Name:CRIPPIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 SE 6TH AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66603-3508
Mailing Address - Country:US
Mailing Address - Phone:877-232-4601
Mailing Address - Fax:
Practice Address - Street 1:121 SE 6TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66603-3508
Practice Address - Country:US
Practice Address - Phone:877-232-4601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-109588183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist