1205908308 NPI number — MRS. BRENDA S RIPPE BS ED

Table of content: MRS. BRENDA S RIPPE BS ED (NPI 1205908308)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205908308 NPI number — MRS. BRENDA S RIPPE BS ED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIPPE
Provider First Name:
BRENDA
Provider Middle Name:
S
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
BS ED
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DOBBERSTEIN
Provider Other First Name:
BRENDA
Provider Other Middle Name:
S
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
BS ED
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1205908308
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6775 RD D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUBBELL
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68375
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-324-4176
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
521 E STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRBURY
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-729-2272
Provider Business Practice Location Address Fax Number:
402-729-2273
Provider Enumeration Date:
11/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 47052851589 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 47052851585 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 47052851590 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 47052851593 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 47052851580 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 47052851587 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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