Provider Demographics
NPI:1134649379
Name:JESSUP-SAVAGE, RUFUS WAYNE (CNP)
Entity Type:Individual
Prefix:
First Name:RUFUS
Middle Name:WAYNE
Last Name:JESSUP-SAVAGE
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:RUFUS
Other - Middle Name:WAYNE
Other - Last Name:JESSUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3330 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-1034
Mailing Address - Country:US
Mailing Address - Phone:330-608-4848
Mailing Address - Fax:
Practice Address - Street 1:3330 WILSON ST
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-1034
Practice Address - Country:US
Practice Address - Phone:330-608-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.370622163W00000X
OHAPRN.CNP.021638363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse