Provider Demographics
NPI:1851399653
Name:RUPPERT, SUSAN DONNA (PHD, RN, NP-C)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:DONNA
Last Name:RUPPERT
Suffix:
Gender:F
Credentials:PHD, RN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 BERTNER AVE # 691
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3901
Mailing Address - Country:US
Mailing Address - Phone:713-500-2164
Mailing Address - Fax:713-500-2171
Practice Address - Street 1:6410 FANNIN ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3014
Practice Address - Country:US
Practice Address - Phone:713-500-3267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX440932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily