Healthcare Provider Details

I. General information

NPI: 1659854925
Provider Name (Legal Business Name): ANN M RUBLE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANN M MONTGOMERY

II. Dates (important events)

Enumeration Date: 09/12/2018
Last Update Date: 11/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7132 HAMILTON AVE
CINCINNATI OH
45231-5234
US

IV. Provider business mailing address

2620 ELM HILL PIKE
NASHVILLE TN
37214-3108
US

V. Phone/Fax

Practice location:
  • Phone: 513-728-2780
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number332919
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.023683
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: