MEDICARE: MARIA N RUUD

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
1	163W00000X	Registered Nurse	R 104369-7	MN

General Provider Information

NPI Number	:	1316923196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA N RUUD

Provider Business Mailing Address
First Line	:	2431 HENNEPIN AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2605
Country	:	US
Telephone Number	:	612-746-8539
Fax Number	:	612-374-1233

Provider Business Practice Location Address
First Line	:	2431 HENNEPIN AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2605
Country	:	US
Telephone Number	:	612-746-8539
Fax Number	:	612-374-1233

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	04/11/2011

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Directions to “ MARIA N RUUD ” Practice Location

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