Provider Demographics
NPI:1124384896
Name:FLUCKER, RUTH MARGARET (MS;RN;PMHNP-BC;CNE)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:MARGARET
Last Name:FLUCKER
Suffix:
Gender:F
Credentials:MS;RN;PMHNP-BC;CNE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3313 E INGLEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-3265
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:70 N MCCLINTOCK DR
Practice Address - Street 2:SUITE 4
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3711
Practice Address - Country:US
Practice Address - Phone:480-464-4431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-07
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4432363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health