Healthcare Provider Details
I. General information
NPI: 1205784139
Provider Name (Legal Business Name): PICC & VASCULAR ACCESS PROFESSIONALS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
209 BUNGALOW DR
NEW BERN NC
28562-8454
US
IV. Provider business mailing address
209 BUNGALOW DR
NEW BERN NC
28562-8454
US
V. Phone/Fax
- Phone: 252-649-8796
- Fax:
- Phone: 252-649-8796
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MICHAEL
ANTHONY
RUFFULE
II
Title or Position: MANAGING MEMBER
Credential: BSN, RN, VA-BC,CCRN
Phone: 252-649-8796