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General NPI Number Information
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NPI Number | 1235579749
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Entity Type | Individual
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Provider Name | NICKI D RIPPETEAU M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 4606 E 184TH ST
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City | BELTON
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State | MO
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Zip | 64012-8323
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Country | US
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Telephone | 806-674-8222
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Fax |
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Provider Business Mailing Address
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Address Line | 4606 E 184TH ST
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City | BELTON
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State | MO
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Zip | 64012-8323
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Country | US
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Telephone | 806-674-8222
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 50707
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 50707
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 50707
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License Number State | AZ
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