Healthcare Provider Details

I. General information

NPI: 1043858947
Provider Name (Legal Business Name): ASHLEY RIPPEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2019
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5130 E MAIN STREET RD
BATAVIA NY
14020-3444
US

IV. Provider business mailing address

29 BUELL ST
BATAVIA NY
14020-3301
US

V. Phone/Fax

Practice location:
  • Phone: 585-344-1421
  • Fax: 585-345-3080
Mailing address:
  • Phone: 585-815-5459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number772184
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: