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General NPI Number Information
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NPI Number | 1588878177
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Entity Type | Individual
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Provider Name | RUTH KOPPEL ROSENBLUM RN, NP
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Gender | Female
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1521 ESTELLE AVE
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City | SAN JOSE
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State | CA
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Zip | 95118-1325
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Country | US
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Telephone | 408-267-0174
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Fax |
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Provider Business Mailing Address
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Address Line | 1521 ESTELLE AVE
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City | SAN JOSE
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State | CA
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Zip | 95118-1325
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Country | US
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Telephone | 408-267-0174
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN 449701
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | NP 8679
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License Number State | CA
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