MEDICARE: RUTH ELLEN BOONE CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	003	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326120767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH ELLEN BOONE CNM

Provider Business Mailing Address
First Line	:	3544 MOUNT GILEAD CHURCH RD
Second Line	:
City	:	PITTSBORO
State	:	NC
Zip	:	27312-7455
Country	:	US
Telephone Number	:	919-418-0145
Fax Number	:	910-907-7463

Provider Business Practice Location Address
First Line	:	3544 MOUNT GILEAD CHURCH RD
Second Line	:
City	:	PITTSBORO
State	:	NC
Zip	:	27312-7455
Country	:	US
Telephone Number	:	919-418-0145
Fax Number	:	910-907-7463

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	12/29/2010

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Directions to “ RUTH ELLEN BOONE CNM” Practice Location

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