Healthcare Provider Details

I. General information

NPI: 1184719700
Provider Name (Legal Business Name): SUZANNE MARIE RUIZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10020 DONALD S. POWERS DRIVE
MUNSTER IN
46321
US

IV. Provider business mailing address

1614 S. CLINE AVE
SCHERERVILLE IN
46375
US

V. Phone/Fax

Practice location:
  • Phone: 219-934-8862
  • Fax: 219-934-8870
Mailing address:
  • Phone: 219-322-2027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71001890A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: