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NPI Code Detail

MEDICARE: ANGELA RUPP RN

MEDICARE:   ANGELA  RUPP  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0808XPsychiatric/Mental Health Registered Nurse828006NV
2363LP0808XPsychiatric/Mental Health Nurse Practitioner3-002138AL
3363LP0808XPsychiatric/Mental Health Nurse Practitioner828006NV

General Provider Information

NPI Number : 1205466752
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA RUPP RN
Provider Business Mailing Address
First Line : 6600 W CHARLESTON BLVD STE 142
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-1050
Country : US
Telephone Number : 702-440-8430
Fax Number :
Provider Business Practice Location Address
First Line : 6600 W CHARLESTON BLVD STE 142
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-1050
Country : US
Telephone Number : 702-440-8430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2020
Last Update Date : 03/17/2025

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Directions to “ ANGELA RUPP RN” Practice Location

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