Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Andrew Conrad Rucker

Individual provider Family Nurse Practitioner · NPI 1083150015

Andrew Conrad Rucker is a Nurse Practitioner in Kingman, Arizona. Qualified in 2016, 10 years ago. Practices with Innova Emergency Medical Associates PC, a 69-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
10
Licensed in
AZ
In the registry since
2017
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Practice location Address checks out

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619
Phone: (928) 757-2101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence AP9899 (AZ)

Record details

NPI number1083150015
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 14, 2017
Last updated in NPPESFebruary 8, 2017
Mailing address3269 N Stockton Hill Rd, Kingman, AZ 86409-3619

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Innova Emergency Medical Associates Pc — 69 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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