=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326344292
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MS. HILDEGARD RUTH EHLERS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/09/2011
-----------------------------------------------------
Last Update Date | 02/09/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2209 UTOPIAN DR E APART. 207
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33763-4259
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-723-2398
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2209 UTOPIAN DR E APART. 207
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33763-4259
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-723-2398
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number | 688046102
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------