Most Relevant Information
Provider Data
| NPI Number: | 1003495557 |
| Provider Name: | PEARL ROSE RUCKER |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | RN230900 |
Most Important Dates
| Enumeration Date: | 04/02/2021 |
| Last Updated: | 12/01/2021 |
Provider Practice Location
9309 BELAIR RD STE D
BALTIMORE
MD
212361605
Practice Location Phone/Fax
| Phone: | 4105057952 |
| Fax: | 4107013845 |
Provider Mailing Location
7652 BELAIR RD STE A
BALTIMORE
MD
212364067
Provider Mailing Phone/Fax
| Phone: | 4109273510 |
| Fax: | 4106562351 |