Healthcare Provider Details

I. General information

NPI: 1114950748
Provider Name (Legal Business Name): ANNA LEE RUELLE D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 MIDDLE ST
LANCASTER NH
03584-3508
US

IV. Provider business mailing address

590 COURT ST
KEENE NH
03431-1719
US

V. Phone/Fax

Practice location:
  • Phone: 603-788-5029
  • Fax:
Mailing address:
  • Phone: 603-354-5454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0286
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: