Provider Demographics
NPI:1487487310
Name:PRIGGE, TESSA MICHELLE
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:MICHELLE
Last Name:PRIGGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TESSA
Other - Middle Name:MICHELLE
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1262 29TH RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:KS
Mailing Address - Zip Code:66937-9329
Mailing Address - Country:US
Mailing Address - Phone:402-363-1065
Mailing Address - Fax:
Practice Address - Street 1:1262 29TH RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:KS
Practice Address - Zip Code:66937-9329
Practice Address - Country:US
Practice Address - Phone:402-363-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other