Courtney Christina Rucks, R.N.

Individual provider Active NPI Registered Nurse · Cottage Grove, WI

NPI 1780997403 · NPPES record last updated Jul 22, 2010

Key facts

NPI
1780997403
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
173551-30 (WI)
Practice address
724 Chestnut CRST
Cottage Grove, WI 53527-9116
Phone
(608) 575-5201
NPI assigned
Jul 22, 2010
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
173551-30WIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 173551-30 WI Yes

Addresses

Primary practice location

724 Chestnut CRST
Cottage Grove, WI 53527-9116

Mailing address

207 Benton St
Cambridge, WI 53523-9438
Phone (608) 575-5201

Other providers in Cottage Grove, WI

All providers in Cottage Grove, WI · Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.