Individual
KATRINA L TRIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
7211 US 45 S, CARRIER MILLS, IL 62917-1305
(618) 209-0498
(618) 724-4628
Mailing address
PO BOX 155, CHRISTOPHER, IL 62822-0155
(618) 724-2401
(618) 724-4628
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004472
IL
Other
Enumeration date
10/01/2012
Last updated
09/08/2022
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