Provider Demographics
NPI:1205396207
Name:RUGE, JANICE ELIZABETH (BS)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:ELIZABETH
Last Name:RUGE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:ELIZABETH
Other - Last Name:AVANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:3445 S SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-1105
Mailing Address - Country:US
Mailing Address - Phone:918-610-3366
Mailing Address - Fax:918-610-3344
Practice Address - Street 1:3445 S SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1105
Practice Address - Country:US
Practice Address - Phone:918-610-3366
Practice Address - Fax:918-610-3344
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator