Provider Demographics
NPI:1104362102
Name:RUIMVELD, EMILY K (NP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:RUIMVELD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 JOHN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5317
Mailing Address - Country:US
Mailing Address - Phone:269-373-1222
Mailing Address - Fax:269-373-6270
Practice Address - Street 1:601 JOHN ST STE 100
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5317
Practice Address - Country:US
Practice Address - Phone:269-373-1222
Practice Address - Fax:269-373-6270
Is Sole Proprietor?:No
Enumeration Date:2017-01-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301405380363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner