Healthcare Provider Details

I. General information

NPI: 1366137705
Provider Name (Legal Business Name): DARCY DEE RUFFO PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 W IRONWOOD DR STE 333
COEUR D ALENE ID
83814-2682
US

IV. Provider business mailing address

1250 W IRONWOOD DR STE 333
COEUR D ALENE ID
83814-2682
US

V. Phone/Fax

Practice location:
  • Phone: 208-626-2433
  • Fax: 888-325-5656
Mailing address:
  • Phone: 208-626-2433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61415809
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number67720
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number67720
License Number StateID
# 4
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN61222156
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: