Provider Demographics
NPI:1952638751
Name:RIPLEY, HEATHER AILEEN
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:AILEEN
Last Name:RIPLEY
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:PO BOX 1642
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82931-1642
Mailing Address - Country:US
Mailing Address - Phone:307-789-0664
Mailing Address - Fax:307-789-1902
Practice Address - Street 1:1425 HIGHWAY 150 S
Practice Address - Street 2:STE 2
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930-5377
Practice Address - Country:US
Practice Address - Phone:307-789-0664
Practice Address - Fax:307-789-1902
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator