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General NPI Number Information
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NPI Number | 1831816701
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Entity Type | Individual
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Provider Name | RUTH BOBERG NP
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Gender | Female
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Dates
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Enumeration Date | 10/21/2022
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 5926 CRAWFORDSVILLE RD UNIT B
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City | INDIANAPOLIS
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State | IN
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Zip | 46224-3722
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Country | US
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Telephone | 317-653-2730
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Fax | 317-321-1935
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Provider Business Mailing Address
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Address Line | PO BOX 746720
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City | ATLANTA
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State | GA
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Zip | 30374-6720
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Country | US
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Telephone | 312-733-9730
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Fax | 773-866-8014
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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 | 71013100A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 71013100A
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License Number State | IN
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