Provider Demographics
NPI:1003944208
Name:RUIZ, WANDA LIZZETTE (BSN)
Entity Type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:LIZZETTE
Last Name:RUIZ
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB.LAS DELICIAS SANTIAGO OPPENHEIMER 1535
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-3905
Mailing Address - Country:US
Mailing Address - Phone:787-984-0791
Mailing Address - Fax:787-984-0791
Practice Address - Street 1:URB.LAS DELICIAS SANTIAGO OPPENHEIMER 1535
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-3905
Practice Address - Country:US
Practice Address - Phone:787-984-0791
Practice Address - Fax:787-984-0791
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR013191163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse