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NPI Code Detail

MEDICARE: CHRIS B. RUGE APRN, BC

MEDICARE: CHRIS B. RUGE APRN, BC
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
1363LF0000XFamily Nurse PractitionerR29549NM
2363LF0000XFamily Nurse PractitionerCNP00581NM

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2NM400318OTHERNMMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932246683
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRIS B. RUGE APRN, BC
Provider Business Mailing Address
First Line : PO BOX 158
Second Line : 538 N. PASEO DE ONATE
City : ESPANOLA
State : NM
Zip : 87532-0158
Country : US
Telephone Number : 505-753-7218
Fax Number : 505-753-5815
Provider Business Practice Location Address
First Line : 1235 EIGHTH ST.
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-4219
Country : US
Telephone Number : 505-425-6788
Fax Number : 505-425-5408
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 07/01/2013

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Directions to “ CHRIS B. RUGE APRN, BC” Practice Location

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