Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 2511 | AR |
NPI | 1033512678 |
---|---|
Provider Name | Robin Cristy Ruppert |
First Address | North Little Rock, AR 72114-1709 |
Second Address | North Little Rock, AR 72114-1709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2014 |
Last Update Date | 26/09/2014 |