Healthcare Provider Details

I. General information

NPI: 1154520195
Provider Name (Legal Business Name): RUTH C. TAGGART NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BELOIT MEMORIAL HOSPITAL 1969 W. HART ROAD
BELOIT WI
53511-2230
US

IV. Provider business mailing address

BELOIT HEALTH SYSTEM INC. 1905 E. HUEBBE PARKWAY
BELOIT WI
53511-1842
US

V. Phone/Fax

Practice location:
  • Phone: 608-363-5971
  • Fax: 608-363-5737
Mailing address:
  • Phone: 608-364-2293
  • Fax: 608-364-5452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209-018593
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9116-33
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number105339
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209.018593
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: