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Individual
JACK RUPPERT MCNELEY-PHELPS
Active
Individual
JACK RUPPERT MCNELEY-PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCP
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LCP 089
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30868014
BCBS OF KC
KS
Enumeration date
06/14/2006
Last updated
10/14/2011
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