Individual
JILLAINE RUPPEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 336-3909
(616) 336-8830
Mailing address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 336-3909
(616) 336-8830
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704225887
MI
363LF0000X
Family Nurse Practitioner
Primary
2005010680
MI
363LF0000X
Family Nurse Practitioner
2021017489
MO
Other
Enumeration date
08/12/2009
Last updated
11/18/2024
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