Provider Demographics
NPI:1033831581
Name:RUTH, KIRSTEN ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:ELIZABETH
Last Name:RUTH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:KIRSTEN
Other - Middle Name:ELIZABETH
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 CARTHAGE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4104
Mailing Address - Country:US
Mailing Address - Phone:919-774-6518
Mailing Address - Fax:
Practice Address - Street 1:555 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4104
Practice Address - Country:US
Practice Address - Phone:919-774-6518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical