Healthcare Provider Details

I. General information

NPI: 1376079947
Provider Name (Legal Business Name): RUTH CHRISTIANSEN N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2017
Last Update Date: 03/28/2019
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:
Mailing address:
  • Phone: 608-364-2293
  • Fax: 608-364-5452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number7571-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7571-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: