Provider Demographics
NPI:1053690487
Name:RIPPETH, JILIAN
Entity type:Individual
Prefix:
First Name:JILIAN
Middle Name:
Last Name:RIPPETH
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 1:729 WOODINGTON DR
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7012
Mailing Address - Country:US
Mailing Address - Phone:614-832-3008
Mailing Address - Fax:
Practice Address - Street 1:729 WOODINGTON DR
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-7012
Practice Address - Country:US
Practice Address - Phone:614-832-3008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH140091164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse