Provider Demographics
NPI:1982912051
Name:RUPP, KAREN JEAN (CPTA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:JEAN
Last Name:RUPP
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 E 45TH ST N
Mailing Address - Street 2:
Mailing Address - City:BEL AIRE
Mailing Address - State:KS
Mailing Address - Zip Code:67226-8817
Mailing Address - Country:US
Mailing Address - Phone:316-744-4109
Mailing Address - Fax:
Practice Address - Street 1:6700 E 45TH ST N
Practice Address - Street 2:
Practice Address - City:BEL AIRE
Practice Address - State:KS
Practice Address - Zip Code:67226-8817
Practice Address - Country:US
Practice Address - Phone:316-744-4109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00358225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant