Kipp Edward Rustenholtz in Okemos - Physician Assistant
Kipp Edward Rustenholtz - NPI 1114193356
Kipp Edward Rustenholtz is a Physician Assistant in Okemos, Michigan. Kipp Edward Rustenholtz practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Kipp Edward Rustenholtz is 1114193356. The last update date is 2018-01-10.
Kipp Edward Rustenholtz's current location address is 1881 W Grand River Ave, Okemos, Michigan. You can contact this provider via phone number 5173392100 and fax number 5173394620. The mailing address for Kipp Edward Rustenholtz is 1881 W Grand River Ave, Okemos, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kipp Edward Rustenholtz |
|---|---|
| Address | 1881 W Grand River Ave, Okemos, Michigan |
| Phone Number | 5173392100 |
| Fax Number | 5173394620 |
| Sole Proprietor | Y |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1114193356 |
|---|---|
| Provider Enumeration Date | 2008-05-07 |
| Last Updated Date | 2018-01-10 |
Provider Mailing Address Detail
| Address | 1881 W Grand River Ave |
|---|---|
| City | Okemos |
| State | Michigan (MI) |
| Post Code | 488641840 |
| Phone Number | 5173392100 |
| Fax Number | 5173394620 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Post Comment/ Review Below
What is the unique provider identifier assigned to Kipp Edward Rustenholtz?
The Kipp Edward Rustenholtz has been issued the NPI (National Provider Identifier) 1114193356 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Kipp Edward Rustenholtz is geographically located?
The Kipp Edward Rustenholtz is physically situated at the following location: 1881 W Grand River Ave, Okemos, MI, 488641840.
What is Kipp Edward Rustenholtz's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kipp Edward Rustenholtz's area of specialization is Physician Assistant, and the corresponding taxonomy code that categorizes this field of practice is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1114193356 to Kipp Edward Rustenholtz?
The Centers for Medicare & Medicaid Services assigned the 1114193356 to Kipp Edward Rustenholtz on 2008-05-07.
As of what date was the information pertaining to Kipp Edward Rustenholtz, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Kipp Edward Rustenholtz, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2018-01-10.