Healthcare Provider Details

I. General information

NPI: 1720335912
Provider Name (Legal Business Name): RUTH HUNTING RN, WCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 HOSPITAL PL
SOLDOTNA AK
99669-7559
US

IV. Provider business mailing address

69075 KAREN CIR
ANCHOR POINT AK
99556-9416
US

V. Phone/Fax

Practice location:
  • Phone: 907-714-4404
  • Fax: 907-714-4696
Mailing address:
  • Phone: 907-235-8894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberNUR R 25269
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: