Individual
KELLY MARIE RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
159 HARTLEY WAY, PEARISBURG, VA 24134-2471
(540) 921-6000
Mailing address
155 OLD VIRGINIA AVE, RICH CREEK, VA 24147-9637
(540) 599-2909
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024192994
VA
Other
Enumeration date
04/10/2025
Last updated
06/05/2025
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