Provider Demographics
NPI:1114093309
Name:RUFF-TROUP, MARY ANN (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ANN
Last Name:RUFF-TROUP
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ANN
Other - Last Name:RUFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10023 WADING CRANE AVE
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46055-9353
Mailing Address - Country:US
Mailing Address - Phone:317-442-8790
Mailing Address - Fax:
Practice Address - Street 1:5695 PEBBLE VILLAGE LN
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-7360
Practice Address - Country:US
Practice Address - Phone:317-450-7722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000567A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily