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General NPI Number Information
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NPI Number | 1881773216
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Entity Type | Individual
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Provider Name | KELLI L. RIPPY M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/05/2006
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Last Update Date | 03/22/2017
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Provider Practice Location Address
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Address Line | 421 NORTH MAIN
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City | MULBERRY
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State | AR
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Zip | 72947-8574
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Country | US
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Telephone | 479-997-1484
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Fax | 479-997-1494
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Provider Business Mailing Address
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Address Line | P.O. BOX 130
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City | RATCLIFF
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State | AR
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Zip | 72951-0130
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Country | US
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Telephone | 479-635-0091
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Fax | 479-635-2010
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E-4805
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License Number State | AR
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