Provider Demographics
NPI:1689203390
Name:DOWD, KATHLEEN RIPPE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:RIPPE
Last Name:DOWD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 POINTER LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-2018
Mailing Address - Country:US
Mailing Address - Phone:314-517-3222
Mailing Address - Fax:
Practice Address - Street 1:59 POINTER LN
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2018
Practice Address - Country:US
Practice Address - Phone:314-517-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-04
Last Update Date:2020-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020008491363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics