Individual
MR. JEROME RUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
201 STATE ST, ERIE, PA 16550-0002
(814) 877-2137
(814) 877-7049
Mailing address
201 STATE ST, ERIE, PA 16550-0002
(814) 877-2137
(814) 877-7049
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN317722L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
054390
PA
Other
Enumeration date
07/18/2006
Last updated
04/28/2020
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