Healthcare Provider Details

I. General information

NPI: 1619268125
Provider Name (Legal Business Name): VICKI A RUMPLER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 12/28/2020
Certification Date: 12/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE A30
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-8251
  • Fax: 216-445-8627
Mailing address:
  • Phone: 216-844-4836
  • Fax: 216-844-2888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCOA.12247-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: