Healthcare Provider Details

I. General information

NPI: 1891115705
Provider Name (Legal Business Name): RUTH EDITH SAMBLE SMITH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2014
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 N MESA ST STE G
EL PASO TX
79902-4000
US

IV. Provider business mailing address

1201 N MESA ST STE G
EL PASO TX
79902-4000
US

V. Phone/Fax

Practice location:
  • Phone: 915-267-1195
  • Fax: 915-267-1193
Mailing address:
  • Phone: 915-267-1195
  • Fax: 915-267-1193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number668112
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: