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General NPI Number Information
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NPI Number | 1699668061
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Entity Type | Individual
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Provider Name | GLADIES RUIZ
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Gender |
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 10432 PATRIOT HWY
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City | FREDERICKSBURG
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State | VA
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Zip | 22408-2628
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Country | US
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Telephone | 757-469-1692
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Fax |
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Provider Business Mailing Address
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Address Line | 9003 LAUREL OAK LN
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-9356
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Country | US
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Telephone |
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 0001195023
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License Number State | VA
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