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Individual

LISA NOELLE RUCKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6406
(816) 271-7986
Mailing address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6406
(816) 271-7986

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
41495
IA
208M00000X
Hospitalist Physician
Primary
2025040342
MO

Other

Enumeration date
06/11/2010
Last updated
11/10/2025
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