Provider Demographics
NPI:1073373916
Name:RUIZ, RYAN-JASON (RN)
Entity Type:Individual
Prefix:
First Name:RYAN-JASON
Middle Name:
Last Name:RUIZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-868 UKUWAI ST
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-5993
Mailing Address - Country:US
Mailing Address - Phone:808-779-0585
Mailing Address - Fax:
Practice Address - Street 1:95-868 UKUWAI ST
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-5993
Practice Address - Country:US
Practice Address - Phone:808-779-0585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-54286163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management