Healthcare Provider Details

I. General information

NPI: 1427882588
Provider Name (Legal Business Name): ANDREW JAMES RUYF RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2024
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14768 MOUNT PERRY RD
MOUNT PERRY OH
43760-9749
US

IV. Provider business mailing address

14768 MOUNT PERRY RD
MOUNT PERRY OH
43760-9749
US

V. Phone/Fax

Practice location:
  • Phone: 740-562-5605
  • Fax:
Mailing address:
  • Phone: 740-562-5605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.430015
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: