Healthcare Provider Details

I. General information

NPI: 1982054227
Provider Name (Legal Business Name): RUTH ANN MONDS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 06/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1152 OAK DR
DOVER DE
19904-4371
US

IV. Provider business mailing address

1152 OAK DR
DOVER DE
19904-4371
US

V. Phone/Fax

Practice location:
  • Phone: 484-886-5911
  • Fax:
Mailing address:
  • Phone: 484-886-5911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberL1-0025295
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: