Healthcare Provider Details

I. General information

NPI: 1003008293
Provider Name (Legal Business Name): RUTH S BRAUN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 08/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11484 B AVE
AUBURN CA
95603-2603
US

IV. Provider business mailing address

11484 B AVE
AUBURN CA
95603-2603
US

V. Phone/Fax

Practice location:
  • Phone: 530-889-7152
  • Fax: 530-889-7198
Mailing address:
  • Phone: 530-889-7152
  • Fax: 530-889-7198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN171659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: