Provider Demographics
NPI:1447677026
Name:RUPPERT, OLGA PATRICIA (PMHP)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:PATRICIA
Last Name:RUPPERT
Suffix:
Gender:F
Credentials:PMHP
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:PATRICIA
Other - Last Name:RUPPERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHP
Mailing Address - Street 1:1215 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-6560
Mailing Address - Country:US
Mailing Address - Phone:308-224-3361
Mailing Address - Fax:
Practice Address - Street 1:1215 14TH AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-6560
Practice Address - Country:US
Practice Address - Phone:308-224-3361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-21
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10152101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health