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NPI Code Detail

MEDICARE: RUTH PARK RN, BSN

MEDICARE: RUTH PARK RN, BSN
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
1163W00000XRegistered NurseRN.427689OH

General Provider Information

NPI Number : 1285132589
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUTH PARK RN, BSN
Provider Business Mailing Address
First Line : 6540 BRIAR HILL CT
Second Line :
City : LIBERTY TWP
State : OH
Zip : 45011-8116
Country : US
Telephone Number : 513-370-8071
Fax Number :
Provider Business Practice Location Address
First Line : 621 S ERIE HWY
Second Line :
City : HAMILTON
State : OH
Zip : 45011-4315
Country : US
Telephone Number : 513-795-7557
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2018
Last Update Date : 02/01/2018

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