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General NPI Number Information
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NPI Number | 1639218217
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Entity Type | Individual
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Provider Name | KRISTY ANN RUIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 2 SHIRCLIFF WAY STE 600
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4762
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Country | US
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Telephone | 904-821-7556
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Fax | 855-707-1416
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Provider Business Mailing Address
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Address Line | PO BOX 748817
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City | ATLANTA
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State | GA
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Zip | 30374-8817
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Country | US
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Telephone | 813-286-0333
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Fax | 813-282-1806
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | P18036
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 64259
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | ME116057
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License Number State | FL
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