| NPI | 1134649379 |
|---|---|
| Former Name | RUFUS WAYNE JESSUP |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.021638) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.370622) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-07-21 |