Provider Demographics
NPI:1053302737
Name:WINGEIER, RUTH MARIE (CNM)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:MARIE
Last Name:WINGEIER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15125 COUNTY 38
Mailing Address - Street 2:
Mailing Address - City:LONG PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:56347
Mailing Address - Country:US
Mailing Address - Phone:320-874-0768
Mailing Address - Fax:320-732-8161
Practice Address - Street 1:18 2ND ST N
Practice Address - Street 2:
Practice Address - City:LONG PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:56347-1118
Practice Address - Country:US
Practice Address - Phone:320-874-0768
Practice Address - Fax:320-732-8161
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-091186-9367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
1006866OtherPREFERRED ONE
637740800OtherMEDICAL ASSISTANCE
HP17423OtherHEALTH PARTNERS
0708012OtherMEDICA HEALTH PLANS
2114078OtherFIRST HEALTH PLAN
122065OtherU-CARE
COMPOtherMMSI
COMPOtherONE HEALTH PLAN/GREATWEST
806969OtherARAZ GROUP/AMERICAS PPO
COMPOtherCHAMPUS
54Q40WIOtherBLUE CROSS BLUE SHIELD
S03474Medicare UPIN
420000194Medicare ID - Type Unspecified