Healthcare Provider Details

I. General information

NPI: 1851165427
Provider Name (Legal Business Name): MICHELLE N RUOSS APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2023
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7588 CENTRAL PARKE BLVD STE 321
MASON OH
45040-6860
US

IV. Provider business mailing address

1126 HAYWARD CIR
MILFORD OH
45150-8025
US

V. Phone/Fax

Practice location:
  • Phone: 513-460-3119
  • Fax:
Mailing address:
  • Phone: 805-822-7257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0035382
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: