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1124497672 NPI number — SAMANTHA JEAN RUCKMAN PHARMD

NPI Number: 1124497672
Health Care Provider/Practitioner: SAMANTHA JEAN RUCKMAN PHARMD

Information about “1124497672” NPI (SAMANTHA JEAN RUCKMAN PHARMD) exists in 1124497672 in HTML format HTML  |  1124497672 in plain Text format TXT  |  1124497672 in PDF (Portable Document Format) PDF  |  1124497672 in an XML format XML  formats.

NPI Number : 1124497672 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124497672",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RUCKMAN",
    "FirstName": "SAMANTHA",
    "MiddleName": "JEAN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PHARMD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "RUSH",
    "OtherFirstName": "SAMANTHA",
    "OtherMiddleName": "JEAN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3579 E 1/2 ROAD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PALISADE",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "81526-9562",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "303-518-3028",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "240 W PARK DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GRAND JUNCTION",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "81505-1450",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "970-208-1252",
    "PracticeLocationAddressFaxNumber": "970-208-1258",
    "EnumerationDate": "09/15/2015",
    "LastUpdateDate": "10/27/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "0021009",
        "LicenseNumberStateCode": "CO",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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