MEDICARE: MRS. COLLEEN HEATHER RUIZ RN

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	163WS0200X	School Registered Nurse	354317	OH

General Provider Information

NPI Number	:	1962872093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COLLEEN HEATHER RUIZ RN

Provider Business Mailing Address
First Line	:	4639 VERMONA DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1021
Country	:	US
Telephone Number	:	513-947-7912
Fax Number	:	513-528-3520

Provider Business Practice Location Address
First Line	:	4639 VERMONA DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1021
Country	:	US
Telephone Number	:	513-947-7912
Fax Number	:	513-528-3520

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

Provider Enumeration Date	:	10/01/2015
Last Update Date	:	04/28/2026

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