Provider Demographics
NPI:1740703016
Name:RUMPH, TERRICA W (CRNP, FNP-C)
Entity type:Individual
Prefix:
First Name:TERRICA
Middle Name:W
Last Name:RUMPH
Suffix:
Gender:F
Credentials:CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 W 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-6156
Mailing Address - Country:US
Mailing Address - Phone:620-343-7828
Mailing Address - Fax:
Practice Address - Street 1:2720 W 15TH AVE
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-6156
Practice Address - Country:US
Practice Address - Phone:620-343-7828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-145258163W00000X
KSF06172609363LF0000X
GARN259782363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse