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Contact Information

KATRELL RUCKER
5 CEDAR RUN LN APT 7
LAKE SAINT LOUIS, MO63367-2707
 Phone: 636-466-7745
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Secured Medical Transport (VAN)

343800000X
Indicates primary specialty

NPI Profile & details for KATRELL RUCKER · (Male)

NPI Number 1588308142
Status Active
Credentials
Entity Individual
Enumeration date 04/20/2022
Last updated 04/20/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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