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General NPI Number Information
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NPI Number | 1831208495
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Entity Type | Individual
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Provider Name | YANIRA C. RUIZ-PERDOMO FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 03/24/2016
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Provider Practice Location Address
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Address Line | NIH NIAMS COMMUNITY HEALTH CLINIC 10 CENTER DRIVE, BLDG 10, RM 6N216
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City | BETHESDA
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State | MD
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Zip | 20892-0001
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Country | US
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Telephone | 301-451-0033
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Fax | 202-673-0012
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Provider Business Mailing Address
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Address Line | 14427 BLACK HORSE CT
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City | CENTREVILLE
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State | VA
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Zip | 20120-2835
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Country | US
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Telephone | 703-371-0805
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0001127160
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License Number State | VA
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