Healthcare Provider Details

I. General information

NPI: 1770962235
Provider Name (Legal Business Name): LAWANDA WITT RUFFNER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2015
Last Update Date: 08/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 HOWARD GAP RD
FLETCHER NC
28732
US

IV. Provider business mailing address

310 OVERLOOK RD STE B
ASHEVILLE NC
28803-3319
US

V. Phone/Fax

Practice location:
  • Phone: 828-483-4330
  • Fax: 828-483-5417
Mailing address:
  • Phone: 828-438-5788
  • Fax: 828-333-5360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5007856
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number239851
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: