Healthcare Provider Details

I. General information

NPI: 1912960469
Provider Name (Legal Business Name): RUTHANN FERIK CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 WHITE POND DR SUITE 300
AKRON OH
44320-1127
US

IV. Provider business mailing address

701 WHITE POND DR SUITE 300
AKRON OH
44320-1127
US

V. Phone/Fax

Practice location:
  • Phone: 330-572-1011
  • Fax: 330-572-1018
Mailing address:
  • Phone: 330-572-1011
  • Fax: 330-572-1018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP02565
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: