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NPI Code Detail

MEDICARE: KNICHOLE LEANNE TRIPP APRN, FNP-BC

MEDICARE: KNICHOLE LEANNE TRIPP APRN, FNP-BC
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
1208D00000XGeneral Practice Physician2023004504IL

General Provider Information

NPI Number : 1487359394
Entity Type Code : Individual
Provider Name (Legal Business Name) : KNICHOLE LEANNE TRIPP APRN, FNP-BC
Provider Business Mailing Address
First Line : 715 WEBB TOWN RD
Second Line :
City : TUNNEL HILL
State : IL
Zip : 62972-3016
Country : US
Telephone Number : 618-771-6178
Fax Number :
Provider Business Practice Location Address
First Line : 211 N BROADWAY
Second Line :
City : GOREVILLE
State : IL
Zip : 62939-2323
Country : US
Telephone Number : 618-995-1002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2023
Last Update Date : 08/07/2024

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Directions to “ KNICHOLE LEANNE TRIPP APRN, FNP-BC” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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