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General NPI Number Information
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NPI Number | 1033449202
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Entity Type | Individual
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Provider Name | RUTH ROBINSON STATEN PHD, APRN-PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/11/2010
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 2821 KLEMPNER WAY
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City | LOUISVILLE
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State | KY
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Zip | 40205
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Country | US
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Telephone | 859-323-8055
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Fax |
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Provider Business Mailing Address
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Address Line | 830 S LIMESTONE
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City | LEXINGTON
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State | KY
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Zip | 40536-0001
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Country | US
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Telephone | 859-323-8055
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 2887S
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3002887
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License Number State | KY
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