Healthcare Provider Details

I. General information

NPI: 1518220649
Provider Name (Legal Business Name): ERIKA LYNN RUUD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2012
Last Update Date: 06/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RAINBOW BLVD MS 2028
KANSAS CITY KS
66103-2937
US

IV. Provider business mailing address

3901 RAINBOW BLVD MS 2028
KANSAS CITY KS
66103-2937
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6245
  • Fax: 913-588-6271
Mailing address:
  • Phone: 913-588-6245
  • Fax: 913-588-6271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number94-07995
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: