Individual
NICOLE RUOPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2432 E MAIN ST, JACKSON, MO 63755-2487
(573) 755-2305
Mailing address
11001 SANDISTAN DR, SAINT LOUIS, MO 63146-5584
(763) 464-7344
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2021032539
MO
Other
Enumeration date
04/02/2020
Last updated
03/19/2024
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