Provider Demographics
NPI:1043807936
Name:KIRKPATRICK, RUTH (RN)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:
Other - Last Name:KIRKPATRICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:3005 S SAINT FRANCIS DR STE 1D
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7004
Mailing Address - Country:US
Mailing Address - Phone:575-808-9839
Mailing Address - Fax:
Practice Address - Street 1:511 W CORDOVA RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-1843
Practice Address - Country:US
Practice Address - Phone:505-983-5546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-25
Last Update Date:2020-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR21754163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse