Provider Demographics
NPI:1396923884
Name:TRIPLETT, KAREN S (NP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:TRIPLETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:WINSTON
Mailing Address - State:OR
Mailing Address - Zip Code:97496-0012
Mailing Address - Country:US
Mailing Address - Phone:541-492-4550
Mailing Address - Fax:541-492-4553
Practice Address - Street 1:92 NW GLENHART AVE
Practice Address - Street 2:
Practice Address - City:WINSTON
Practice Address - State:OR
Practice Address - Zip Code:97496
Practice Address - Country:US
Practice Address - Phone:541-492-4550
Practice Address - Fax:541-492-4553
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200350097NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
896633008OtherBLUE CROSS
ORR85954Medicare UPIN