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Individual

ROBERTA TRIPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
111 S FRONT STREET, HARRISBURG, PA 17101-1020
(717) 782-5283
(717) 782-5192
Mailing address
118 WASHINGTON STREET, HARRISBURG, PA 17104-1612

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
513983
PA
133V00000X
Registered Dietitian
Primary
DN000026
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1021062260001
PA
01
9068015
CIGNA
PA
Enumeration date
03/26/2008
Last updated
04/27/2010
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