Provider Demographics
NPI:1205554490
Name:TRIPLETT, CASSIE
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:
Last Name:TRIPLETT
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 1:840 FALLBROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-6648
Mailing Address - Country:US
Mailing Address - Phone:402-438-8870
Mailing Address - Fax:402-438-8871
Practice Address - Street 1:840 FALLBROOK BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-6648
Practice Address - Country:US
Practice Address - Phone:402-438-8870
Practice Address - Fax:402-438-8871
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13199183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist