Provider Demographics
NPI:1053060301
Name:RUIZ, AMY JOYCE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:JOYCE
Last Name:RUIZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 749495
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9495
Mailing Address - Country:US
Mailing Address - Phone:239-432-8331
Mailing Address - Fax:813-321-1296
Practice Address - Street 1:41201 SCHADDEN RD STE 2
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-2249
Practice Address - Country:US
Practice Address - Phone:440-324-0401
Practice Address - Fax:440-324-0405
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-241923163WR0400X
OH0031517363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation