Provider Demographics
NPI:1225141294
Name:RUHL, KATHLEEN BURNS (PMHNP-BC, CNP)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:BURNS
Last Name:RUHL
Suffix:
Gender:F
Credentials:PMHNP-BC, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 E PATRICK HENRY HWY
Mailing Address - Street 2:
Mailing Address - City:BURKEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23922-3460
Mailing Address - Country:US
Mailing Address - Phone:434-767-4579
Mailing Address - Fax:
Practice Address - Street 1:5001 E PATRICK HENRY HWY
Practice Address - Street 2:
Practice Address - City:BURKEVILLE
Practice Address - State:VA
Practice Address - Zip Code:23922-3460
Practice Address - Country:US
Practice Address - Phone:434-767-4579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC198753363LP0808X
VA0024167811363LP0808X
OK41944363LP0808X
OKN0230006363LP0808X
MN210652 0363LP0808X
NYF401627 1363LP0808X
VT026 0021464363LP0808X
NC950021363LP0808X
OKR 100368363LP0808X
NY468946 1363LP0808X
MA207417364SP0808X
VA0017139174363LP0808X
VA0001247244363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6113004Medicaid
VA1225141294Medicaid
NCQ45065Medicare UPIN
NC2592392Medicare ID - Type Unspecified
VA1225141294Medicaid