Provider Demographics
NPI:1033209010
Name:GROTHOUSE, RUTH ANN (C-NP)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ANN
Last Name:GROTHOUSE
Suffix:
Gender:F
Credentials:C-NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:750 W HIGH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-2969
Mailing Address - Country:US
Mailing Address - Phone:419-229-6781
Mailing Address - Fax:419-229-3490
Practice Address - Street 1:750 W HIGH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-2969
Practice Address - Country:US
Practice Address - Phone:419-229-6781
Practice Address - Fax:419-229-3490
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN168050363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS88059Medicare UPIN