Provider Demographics
NPI:1972491785
Name:PEREZ-RUPP, VASHTI D
Entity type:Individual
Prefix:
First Name:VASHTI
Middle Name:D
Last Name:PEREZ-RUPP
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:RR 2 BOX 836 APT 1
Mailing Address - Street 2:RR 2 BOX 836 APT 1
Mailing Address - City:BAYARD
Mailing Address - State:NE
Mailing Address - Zip Code:69334
Mailing Address - Country:US
Mailing Address - Phone:531-257-4855
Mailing Address - Fax:
Practice Address - Street 1:RR 2 BOX 836 APT 1
Practice Address - Street 2:RR 2 BOX 836 APT 1
Practice Address - City:BAYARD
Practice Address - State:NE
Practice Address - Zip Code:69334
Practice Address - Country:US
Practice Address - Phone:531-257-4855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEH12877565372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider