Provider Demographics
NPI:1851970453
Name:RIPPEY, JINETTIA BENA
Entity Type:Individual
Prefix:
First Name:JINETTIA
Middle Name:BENA
Last Name:RIPPEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4564 NATCHEZ AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45416-1540
Mailing Address - Country:US
Mailing Address - Phone:937-361-7722
Mailing Address - Fax:
Practice Address - Street 1:4564 NATCHEZ AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45416-1540
Practice Address - Country:US
Practice Address - Phone:937-361-7722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.327175163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse