Healthcare Provider Details

I. General information

NPI: 1710800206
Provider Name (Legal Business Name): CHYNA NIYAE GERMANY-RUCKER BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2709 STREAMFIRE CV
ANTIOCH TN
37013-1190
US

IV. Provider business mailing address

2709 STREAMFIRE CV
ANTIOCH TN
37013-1190
US

V. Phone/Fax

Practice location:
  • Phone: 925-445-8029
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number253019
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: