Provider Demographics
NPI:1811234263
Name:RUPPAL, LINDSEY ALEXANDRIA
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:ALEXANDRIA
Last Name:RUPPAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5768 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:VASSAR
Mailing Address - State:MI
Mailing Address - Zip Code:48768-9596
Mailing Address - Country:US
Mailing Address - Phone:989-545-0764
Mailing Address - Fax:
Practice Address - Street 1:5768 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:VASSAR
Practice Address - State:MI
Practice Address - Zip Code:48768-9596
Practice Address - Country:US
Practice Address - Phone:989-545-0764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program