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General NPI Number Information
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NPI Number | 1588901235
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Entity Type | Individual
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Provider Name | KARLA SUE TRIPP RN, MSN, LMT, LDHS
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Gender | Female
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Dates
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Enumeration Date | 01/14/2013
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 2151 FERGUSON RD STE 101
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City | JACKSON
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State | MI
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Zip | 49203-5563
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Country | US
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Telephone | 517-474-0993
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Fax |
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Provider Business Mailing Address
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Address Line | 135 EDGEWATER DR
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City | MICHIGAN CENTER
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State | MI
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Zip | 49254-1416
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Country | US
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Telephone | 906-630-1050
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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 | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 4704273211
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704273211
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 4704273211
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 4704273211
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 163WC1600X
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Taxonomy Name | Continuing Education/Staff Development Registered Nurse
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License Number | 4704273211
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 4704273211
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 163WN1003X
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Taxonomy Name | Nutrition Support Registered Nurse
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License Number | 4704273211
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License Number State | MI
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Taxonomy #8
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Taxonomy Code | 163WH1000X
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Taxonomy Name | Hospice Registered Nurse
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License Number | 4704273211
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License Number State | MI
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Taxonomy #9
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Taxonomy Code | 163WR0400X
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Taxonomy Name | Rehabilitation Registered Nurse
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License Number | 4704273211
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License Number State | MI
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Taxonomy #10
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Taxonomy Code | 163WP0000X
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Taxonomy Name | Pain Management Registered Nurse
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License Number | 4704273211
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License Number State | MI
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Taxonomy #11
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 7501000642
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License Number State | MI
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Taxonomy #12
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Taxonomy Code | 163WM1400X
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Taxonomy Name | Nurse Massage Therapist (NMT)
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License Number | 4704273211
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License Number State | MI
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