Healthcare Provider Details

I. General information

NPI: 1407849748
Provider Name (Legal Business Name): RUTH KAEMMERLEN EFIRD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 HOMESTEAD RD
CHAPEL HILL NC
27516-9087
US

IV. Provider business mailing address

119 HOLLOW OAK DR
DURHAM NC
27713-8643
US

V. Phone/Fax

Practice location:
  • Phone: 919-968-2022
  • Fax: 919-968-2013
Mailing address:
  • Phone: 919-490-0652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200273
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: