Provider Demographics
NPI:1750303053
Name:CRIPPS, SUSANNAH H (RPH)
Entity type:Individual
Prefix:
First Name:SUSANNAH
Middle Name:H
Last Name:CRIPPS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 BARON BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37166-7454
Mailing Address - Country:US
Mailing Address - Phone:334-796-1548
Mailing Address - Fax:
Practice Address - Street 1:445 S JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3410
Practice Address - Country:US
Practice Address - Phone:931-528-8011
Practice Address - Fax:931-372-8557
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11447183500000X
AL13130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist