Provider Demographics
NPI:1861799702
Name:RUPP, LOTTIE (BS, RRT)
Entity type:Individual
Prefix:
First Name:LOTTIE
Middle Name:
Last Name:RUPP
Suffix:
Gender:F
Credentials:BS, RRT
Other - Prefix:
Other - First Name:LOTTIE
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, RRT
Mailing Address - Street 1:10333 N ORACLE RD
Mailing Address - Street 2:APT. 21107
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-5100
Mailing Address - Country:US
Mailing Address - Phone:520-225-0648
Mailing Address - Fax:
Practice Address - Street 1:3350 E GRANT RD
Practice Address - Street 2:SUITE 200
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2800
Practice Address - Country:US
Practice Address - Phone:520-326-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ009615227900000X
PAYM010765227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered