Provider Demographics
NPI:1356504328
Name:RUPPERT, NANCY ALICE (FNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ALICE
Last Name:RUPPERT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 833
Mailing Address - Street 2:
Mailing Address - City:STAR
Mailing Address - State:NC
Mailing Address - Zip Code:27356-0833
Mailing Address - Country:US
Mailing Address - Phone:910-428-3524
Mailing Address - Fax:
Practice Address - Street 1:217 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NC
Practice Address - Zip Code:27371-3201
Practice Address - Country:US
Practice Address - Phone:910-572-1393
Practice Address - Fax:910-572-8177
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC088687363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily