| NPI | 1093478349 |
|---|---|
| Former Name | KIMBERLY MICHELLE RUPPERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP027319) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 110930) |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2023-03-20 |