Provider Demographics
NPI:1710381835
Name:TRIPP, KATHRYN (ARNP-FNP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:TRIPP
Suffix:
Gender:F
Credentials:ARNP-FNP
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:DANKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-1239
Mailing Address - Country:US
Mailing Address - Phone:573-629-3400
Mailing Address - Fax:573-629-3414
Practice Address - Street 1:6500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-6890
Practice Address - Country:US
Practice Address - Phone:573-629-3480
Practice Address - Fax:573-629-3987
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA076247363LF0000X
MO2021009934363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily