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General NPI Number Information
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NPI Number | 1902867245
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Entity Type | Individual
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Provider Name | DEBORAH KATHLEEN RUPAE FNP
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Gender | Female
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 13995 W. STATLER BLVD
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City | SURPRISE
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State | AZ
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Zip | 85374
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Country | US
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Telephone | 623-478-3100
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Fax | 623-478-3300
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Provider Business Mailing Address
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Address Line | 13995 W. STATLER BLVD STE 200
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City | SURPRISE
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State | AZ
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Zip | 85374-5501
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Country | US
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Telephone | 623-478-3100
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Fax | 623-478-3300
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP30005854
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 200150031NP
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License Number State | OR
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