Rupert, Loucresie Nichelle

Rupert, Loucresie Nichelle is an sole proprietor health care provider with primary practice located at 1836 South Ave , La Crosse WI 54601. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is her primary health care specialty. Rupert, Loucresie Nichelle can be contacted via phone (608) 782-7300.

Contact Information

Primary practice address
1836 South Ave La Crosse WI 54601
Phone: (608) 782-7300
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 68599 Wisconsin

Profile Details

NPI number 1295056471
LBN Legal business name Rupert, Loucresie Nichelle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 22nd, 2010
Last updated Jan 3rd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295056471 NPPES
Wisconsin MEDICAID 1295056471

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