Provider Demographics
NPI:1891204475
Name:GRIPPIN, LEA A (FNP-BC)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:A
Last Name:GRIPPIN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 313
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:MA
Mailing Address - Zip Code:01053-0313
Mailing Address - Country:US
Mailing Address - Phone:413-727-3901
Mailing Address - Fax:413-727-3902
Practice Address - Street 1:269 LOCUST ST STE 108
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01062-2003
Practice Address - Country:US
Practice Address - Phone:413-586-0769
Practice Address - Fax:888-715-2360
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-26
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA195578363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily