Healthcare Provider Details

I. General information

NPI: 1184102543
Provider Name (Legal Business Name): NOELLE ARIEL TRIPP RN, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2018
Last Update Date: 07/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8720 14TH AVE S
SEATTLE WA
98108-4807
US

IV. Provider business mailing address

119 GREAT NECK RD
WATERFORD CT
06385-3527
US

V. Phone/Fax

Practice location:
  • Phone: 206-762-3730
  • Fax:
Mailing address:
  • Phone: 262-389-4075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60879537
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: