Individual
JENNA TAYLOR RUPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
451 HEALTH PKWY, SUITE A, PAW PAW, MI 49079-8242
(269) 657-2550
(269) 657-2285
Mailing address
451 HEALTH PKWY, SUITE A, PAW PAW, MI 49079-8242
(269) 657-2550
(269) 657-2285
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01075489A
IN
207Q00000X
Family Medicine Physician
11016450A
IN
207Q00000X
Family Medicine Physician
Primary
4301108074
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000948449
BCBS E BLAIR WARNER
IN
05
—
201112790
—
IN
Enumeration date
05/10/2012
Last updated
11/27/2023
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