Healthcare Provider Details

I. General information

NPI: 1447127923
Provider Name (Legal Business Name): KIMBERLY JOY RUIZ APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. KIMBERLY JOY BAKER

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PROSPECT AVE FL 3
HACKENSACK NJ
07601-1915
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-5329
  • Fax: 551-996-0115
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number26NJ00343200
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: