Healthcare Provider Details

I. General information

NPI: 1659153690
Provider Name (Legal Business Name): SANDRA KAYE RUPPE MSN, BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

695 W FLEMING DR
MORGANTON NC
28655-4450
US

IV. Provider business mailing address

136 CAMP CREEK RD
UNION MILLS NC
28167-7915
US

V. Phone/Fax

Practice location:
  • Phone: 828-580-3278
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5019173
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: