Provider Demographics
NPI:1083889711
Name:PAPIN, MARY ELLEN RUIZ (DPT)
Entity Type:Individual
Prefix:
First Name:MARY ELLEN
Middle Name:RUIZ
Last Name:PAPIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1437 OZZIE SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7631
Mailing Address - Country:US
Mailing Address - Phone:702-912-2820
Mailing Address - Fax:702-912-2820
Practice Address - Street 1:1437 OZZIE SMITH AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7631
Practice Address - Country:US
Practice Address - Phone:702-912-2820
Practice Address - Fax:702-912-2820
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4332225100000X, 2251G0304X
CA274132251G0304X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics