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NPI Code Detail

MEDICARE: HAYDEN RUIZ RN

MEDICARE: HAYDEN RUIZ RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner1178720TX

General Provider Information

NPI Number : 1265194823
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAYDEN RUIZ RN
Provider Business Mailing Address
First Line : PO BOX 2603
Second Line :
City : FORT WORTH
State : TX
Zip : 76113-2603
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19965 FM 3175
Second Line :
City : LYTLE
State : TX
Zip : 78052-3481
Country : US
Telephone Number : 210-357-0335
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2021
Last Update Date : 10/23/2024

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