Individual
PEARL ROSE RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9309 BELAIR RD STE D, BALTIMORE, MD 21236-1605
(410) 505-7952
(410) 701-3845
Mailing address
7652 BELAIR RD STE A, BALTIMORE, MD 21236-4067
(410) 927-3510
(410) 656-2351
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AC004015
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN230900
GA
Other
Enumeration date
04/02/2021
Last updated
12/01/2021
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