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Individual

JENNA E RUPERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
317 S SALINA ST, SYRACUSE, NY 13202-1601
(607) 222-9482
Mailing address
317 S SALINA ST, SYRACUSE, NY 13202-1601
(607) 222-9482

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
636347
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401712
NY

Other

Enumeration date
08/11/2014
Last updated
08/11/2014
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