Healthcare Provider Details

I. General information

NPI: 1780879676
Provider Name (Legal Business Name): MARK KRIPAL HEARING & AUDIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 01/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 WILLIAM AVE
NORTH PLATTE NE
69101-6556
US

IV. Provider business mailing address

PO BOX 795
NORTH PLATTE NE
69103-0795
US

V. Phone/Fax

Practice location:
  • Phone: 308-532-3330
  • Fax: 308-532-3334
Mailing address:
  • Phone: 308-532-3330
  • Fax: 308-532-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number166
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number639
License Number StateNE

VIII. Authorized Official

Name: LORI JAYNE KRIPAL
Title or Position: OFFICE MANAGER, OWNER
Credential:
Phone: 308-532-3334