Provider Demographics
NPI:1043364904
Name:NELSON, RUTH ANN (RPH)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ANN
Last Name:NELSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2046 HUNTERS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-7500
Mailing Address - Country:US
Mailing Address - Phone:641-422-0221
Mailing Address - Fax:
Practice Address - Street 1:115 GILMAN ST.
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:IA
Practice Address - Zip Code:50475
Practice Address - Country:US
Practice Address - Phone:641-892-4640
Practice Address - Fax:641-892-4745
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA14414183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist