Provider Demographics
NPI:1043385826
Name:LEE, RUTH EBERT (CNS)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:EBERT
Last Name:LEE
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2301
Mailing Address - Country:US
Mailing Address - Phone:740-592-3091
Mailing Address - Fax:740-594-5642
Practice Address - Street 1:809 FARSON ST UNIT 110
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1067
Practice Address - Country:US
Practice Address - Phone:740-423-8095
Practice Address - Fax:740-423-8096
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNS07334364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0099761Medicaid
OHNS07334OtherCLINICAL NURSE SPECIALIST
OHH280620Medicare UPIN