Provider Demographics
NPI:1013230614
Name:FIEGELMAN, RUTHANN CLAUDIA (LPN)
Entity Type:Individual
Prefix:
First Name:RUTHANN
Middle Name:CLAUDIA
Last Name:FIEGELMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15981 PIONEER ROAD
Mailing Address - Street 2:
Mailing Address - City:NEW UNDERWOOD
Mailing Address - State:SD
Mailing Address - Zip Code:57761-0304
Mailing Address - Country:US
Mailing Address - Phone:605-209-7246
Mailing Address - Fax:
Practice Address - Street 1:15981 PIONEER ROAD
Practice Address - Street 2:
Practice Address - City:NEW UNDERWOOD
Practice Address - State:SD
Practice Address - Zip Code:57761-0304
Practice Address - Country:US
Practice Address - Phone:605-209-7246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDPO10266164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse