Provider Demographics
NPI:1548672801
Name:TRIPLETT, ANGELINA (RN)
Entity type:Individual
Prefix:
First Name:ANGELINA
Middle Name:
Last Name:TRIPLETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 HESS LN
Mailing Address - Street 2:
Mailing Address - City:RAY
Mailing Address - State:OH
Mailing Address - Zip Code:45672-9501
Mailing Address - Country:US
Mailing Address - Phone:740-703-6412
Mailing Address - Fax:
Practice Address - Street 1:303 HESS LN
Practice Address - Street 2:
Practice Address - City:RAY
Practice Address - State:OH
Practice Address - Zip Code:45672-9501
Practice Address - Country:US
Practice Address - Phone:740-703-6412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN277213163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse