Individual
GERALDINE RUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
306 E MAUMEE ST, SUITE 301, ANGOLA, IN 46703-2038
(269) 660-1670
(269) 660-0666
Mailing address
7070 E DR N, BATTLE CREEK, MI 49014-8562
(269) 660-1670
(269) 660-0666
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
NP07202
OH
363L00000X
Nurse Practitioner
4704189142
MI
363L00000X
Nurse Practitioner
Primary
71005085A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1092419
—
OH
01
—
500030618
RAILROAD
OH
Enumeration date
03/22/2007
Last updated
04/08/2015
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