Kimberly Rucker
Individual provider Active NPI Attendant Care Provider · Faucett, MO
NPI 1396394201 · NPPES record last updated May 7, 2020
Key facts
- NPI
- 1396394201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Attendant Care Provider 3747A0650X
- Practice address
- 710 S.E. Grand DD Terrace
Faucett, MO 64448 - Phone
- (314) 652-4100
- NPI assigned
- Sep 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Yes |
Addresses
Primary practice location
710 S.E. Grand DD Terrace
Faucett, MO 64448
Mailing address
710 S.E. Grand DD Terrace
Faucett, MO 64448
Other providers in Faucett, MO
- Tammy L. Addison
- County of Buchanan School District R-5
- Cynthia Debey, LCSW, LLC
- Cynthia Debey
- Northwest Health Services, Inc.
- Taylor Triplett
All providers in Faucett, MO · Attendant Care Provider in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.