Healthcare Provider Details

I. General information

NPI: 1295811628
Provider Name (Legal Business Name): RUTH G. GINGERICH CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25700 CANADA DR
CARMEL CA
93923-8924
US

IV. Provider business mailing address

PO BOX 223360
CARMEL CA
93922-3360
US

V. Phone/Fax

Practice location:
  • Phone: 831-624-9679
  • Fax: 831-625-5521
Mailing address:
  • Phone: 831-624-9679
  • Fax: 831-625-5521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number372084
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: