Provider Demographics
NPI:1144044470
Name:RUUD, ANGELA A (BSN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:A
Last Name:RUUD
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:A
Other - Last Name:MCKENZIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1532 MUTINEER PL
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-8983
Mailing Address - Country:US
Mailing Address - Phone:701-471-3416
Mailing Address - Fax:
Practice Address - Street 1:2101 ELM ST N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2417
Practice Address - Country:US
Practice Address - Phone:701-221-9152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR31780163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care