Individual
KNICHOLE LEANNE TRIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
211 N BROADWAY, GOREVILLE, IL 62939-2323
(618) 995-1002
Mailing address
715 WEBB TOWN RD, TUNNEL HILL, IL 62972-3016
(618) 771-6178
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
2023004504
IL
Other
Enumeration date
03/31/2023
Last updated
08/07/2024
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