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NPI Code Detail

MEDICARE: MS. JESSICA RIBBLE LPN

MEDICARE: MS. JESSICA RIBBLE LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse2015040300MO

General Provider Information

NPI Number : 1144794199
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JESSICA RIBBLE LPN
Provider Business Mailing Address
First Line : 760 S KINGSHIGHWAY ST STE F
Second Line :
City : CAPE GIRARDEAU
State : MO
Zip : 63703-7676
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 760 S KINGSHIGHWAY ST STE F
Second Line :
City : CAPE GIRARDEAU
State : MO
Zip : 63703-7676
Country : US
Telephone Number : 573-335-4333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2019
Last Update Date : 01/13/2019

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Directions to “ MS. JESSICA RIBBLE LPN” Practice Location

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