Healthcare Provider Details

I. General information

NPI: 1528507738
Provider Name (Legal Business Name): RUTH A KAISER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SENTARA CIR
WILLIAMSBURG VA
23188-5713
US

IV. Provider business mailing address

PO BOX 641057
PITTSBURGH PA
15264-1057
US

V. Phone/Fax

Practice location:
  • Phone: 800-655-2656
  • Fax: 412-822-7411
Mailing address:
  • Phone: 800-655-2656
  • Fax: 412-822-7411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024174273
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: