Healthcare Provider Details

I. General information

NPI: 1386216257
Provider Name (Legal Business Name): CHARMINE RIPARIP NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15959 HALL RD STE LL104
MACOMB MI
48044-5364
US

IV. Provider business mailing address

15959 HALL RD STE LL104
MACOMB MI
48044-5364
US

V. Phone/Fax

Practice location:
  • Phone: 586-799-1212
  • Fax:
Mailing address:
  • Phone: 586-799-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704302440
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2021033980
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: