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General NPI Number Information
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NPI Number | 1316968266
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Entity Type | Individual
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Provider Name | STEFAN J RIPICH CNP
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Gender | Male
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 21337 BUSH ST
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City | MIDDLETOWN
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State | CA
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Zip | 95461
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Country | US
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Telephone | 707-987-3311
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Fax | 707-987-2455
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Provider Business Mailing Address
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Address Line | 21337 BUSH STREET
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City | MIDDLETOWN
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State | CA
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Zip | 95461
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Country | US
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Telephone | 707-987-3311
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Fax | 707-987-2455
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5900
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License Number State | CA
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