Healthcare Provider Details

I. General information

NPI: 1184360646
Provider Name (Legal Business Name): TAMARA JO RUOFF APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMMY LAUDENKLOS

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 ARIES DR
LINCOLN NE
68512-9100
US

IV. Provider business mailing address

4825 CRESTHAVEN DR
LINCOLN NE
68516-1236
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-2987
  • Fax:
Mailing address:
  • Phone: 402-649-7240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number114221
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: