Individual
MR. LARRY E RUPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 W 4TH ST, SUITE 310, COOKEVILLE, TN 38501-2448
(931) 528-7877
(931) 526-3261
Mailing address
100 W 4TH ST, SUITE 310, COOKEVILLE, TN 38501-2448
(931) 528-7877
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
8945
TN
367500000X
Certified Registered Nurse Anesthetist
RN0000044208
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3026920
BCBST
TN
05
—
3602647
—
TN
05
—
74289257
—
KY
Enumeration date
10/11/2005
Last updated
04/16/2008
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