Healthcare Provider Details

I. General information

NPI: 1861439903
Provider Name (Legal Business Name): JANET RUFFIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4713 W NASH ST
MILWAUKEE WI
53216-2918
US

IV. Provider business mailing address

3900 W BROWN DEER RD
MILWAUKEE WI
53209-1220
US

V. Phone/Fax

Practice location:
  • Phone: 414-444-5550
  • Fax:
Mailing address:
  • Phone: 414-837-6299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number117835030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: