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General NPI Number Information
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NPI Number | 1467804856
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Entity Type | Individual
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Provider Name | JOBINA SUSANNAH RUIZ CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/08/2016
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 1486 COMMONWEALTH AVE APT 6
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City | BRIGHTON
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State | MA
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Zip | 02135-4526
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Country | US
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Telephone | 347-387-6065
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Fax |
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Provider Business Mailing Address
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Address Line | DEPT# 42065 PO BOX 650823
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City | DALLAS
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State | TX
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Zip | 75265
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Country | US
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Telephone | 602-242-4484
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 240300
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN128055
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 9432765
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License Number State | FL
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