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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KATRELL RUCKER

Active Sole Proprietor

KATRELL RUCKER is a Air Carrier healthcare provider located in LAKE ST LOUIS, Missouri. NPI 1588308142 is currently active in the NPPES registry. Verify at CMS.

Air Carrier · LAKE ST LOUIS, MO

Registration Details

NPI Number
1588308142
Provider Type
Individual
Gender
Male
NPI Issued
Apr 20, 2022 (4.3411100914999 yrs)
Last Updated
Apr 20, 2022
Sole Proprietor
Yes

Practice Information

Address
5 CEDAR RUN LN APT 7
LAKE ST LOUIS, MO, 633672707
Browse MO providers · Browse ZIP 63367
Phone
6364667745
Primary Specialty
Air Carrier
343800000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.