Healthcare Provider Details

I. General information

NPI: 1669270328
Provider Name (Legal Business Name): KATHRYN RUGGIERO APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10050 RALSTON RD # 1
ARVADA CO
80004-4974
US

IV. Provider business mailing address

5403 W 96TH AVE APT 1220
WESTMINSTER CO
80020-5714
US

V. Phone/Fax

Practice location:
  • Phone: 720-583-6145
  • Fax:
Mailing address:
  • Phone: 203-927-4204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1000615-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: