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BETTY L RUCKER LPN

>> Licensed Practical Nurse >> Nursing Service Providers

Registrant NPI Number: 1417213133

Individual Registrant:
 BETTY L RUCKER LPN
Gender: F
Not Sole Proprietor

Location and contact information for practice:
14410 ROUTE 37  JOHNSTON CITY, IL 62951-3166 US
Tel: 618-983-6911  Fax: --

Contact information for business:
PO BOX 155  CHRISTOPHER, IL 62822-0155 US
Tel: 618-724-2436  Fax: --

Registration Information:
NPI: 1417213133
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y164W00000XNursing Service Providers
Licensed Practical Nurse
IL043.061782

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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