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General NPI Number Information
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NPI Number | 1114846615
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Entity Type | Individual
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Provider Name | RU SI NP
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Gender | Female
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/24/2026
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Provider Practice Location Address
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Address Line | 407 S SCHWARTZ AVE STE 202
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City | FARMINGTON
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State | NM
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Zip | 87401-5925
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Country | US
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Telephone | 505-609-6770
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Fax |
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Provider Business Mailing Address
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Address Line | 204 E VALLEY VIEW DR
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City | BAYFIELD
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State | CO
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Zip | 81122-9297
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Country | US
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Telephone | 573-275-9396
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.1002112-NP
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License Number State | CO
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