Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN217510 | MA |
NPI | 1013907179 |
---|---|
Provider Name | Jodi Ripka |
First Address | Holyoke, MA 01040-2676 |
Second Address | Holyoke, MA 01040-2676 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2005 |
Last Update Date | 22/07/2021 |