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General NPI Number Information
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NPI Number | 1245001601
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Entity Type | Individual
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Provider Name | RUBY MAICHAO VANG FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 2025 UPPER 45TH ST E
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55077-1337
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Country | US
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Telephone | 651-410-0911
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Fax | 612-345-4710
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Provider Business Mailing Address
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Address Line | 2025 UPPER 45TH ST E
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55077-1337
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Country | US
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Telephone | 651-410-0911
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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 | 2023167559
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License Number State | MN
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