MEDICARE: MS. RUTH A CHAZA-NDLOVU CNP

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	163W00000X	Registered Nurse	RN332159	OH
2	363L00000X	Nurse Practitioner	COA.18168-NP	OH

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	:	1326241852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RUTH A CHAZA-NDLOVU CNP

Provider Business Mailing Address
First Line	:	PO BOX 746071
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6071
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:	773-866-8014

Provider Business Practice Location Address
First Line	:	16888 HARVARD AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-2208
Country	:	US
Telephone Number	:	216-682-7703
Fax Number	:	216-236-7768

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

Provider Enumeration Date	:	06/11/2007
Last Update Date	:	08/17/2023

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