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Individual

MICHAEL P. RUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1218 N MAIN ST, PUEBLO, CO 81003-2828
(719) 543-7877
(719) 543-7882
Mailing address
1218 N MAIN ST, PUEBLO, CO 81003-2828
(719) 543-7877
(719) 543-7882

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN#R79369
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
APN.0991504
CO
367500000X
Certified Registered Nurse Anesthetist
CRNA#CTP-00203
AR

Other

Enumeration date
05/14/2012
Last updated
04/28/2017
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