Provider Demographics
NPI:1033553516
Name:RUPPENSTEIN, NICOLE DANIELLE (RN)
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:DANIELLE
Last Name:RUPPENSTEIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 GEORGE CT
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-1316
Mailing Address - Country:US
Mailing Address - Phone:631-672-9423
Mailing Address - Fax:631-473-4755
Practice Address - Street 1:7 GEORGE CT
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-1316
Practice Address - Country:US
Practice Address - Phone:631-672-9423
Practice Address - Fax:631-473-4755
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY662641163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse