Basic Information
| Provider Information | |||||||||
| NPI: | 1699058073 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUPCICH | ||||||||
| FirstName: | LAURA BETH | ||||||||
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| NamePrefix: | MRS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 MASON FARM RD | ||||||||
| Address2: | CB 7248 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275145307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199667049 | ||||||||
| FaxNumber: | 9198435309 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 MEADOWMONT VILLAGE CIR | ||||||||
| Address2: | STE 203 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275177518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9849745703 | ||||||||
| FaxNumber: | 9849745737 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2011 | ||||||||
| LastUpdateDate: | 02/13/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 001002947 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.