Healthcare Provider Details

I. General information

NPI: 1427171917
Provider Name (Legal Business Name): RUTH SWISHER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W MAIN ST U.W.WHITEWATER
WHITEWATER WI
53190-1705
US

IV. Provider business mailing address

800 W MAIN ST U.W.WHITEWATER
WHITEWATER WI
53190-1705
US

V. Phone/Fax

Practice location:
  • Phone: 262-474-1300
  • Fax: 262-472-5608
Mailing address:
  • Phone: 262-474-1300
  • Fax: 262-472-5608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License Number64586-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: