Provider Demographics
NPI:1235379876
Name:RUCH, NANCY LAKEY (MSN, NNP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LAKEY
Last Name:RUCH
Suffix:
Gender:F
Credentials:MSN, NNP
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:KATHRYN
Other - Last Name:LAKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, NNP
Mailing Address - Street 1:877 JEFFERSON AVE RM 201
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-2807
Mailing Address - Country:US
Mailing Address - Phone:901-448-4750
Mailing Address - Fax:901-448-6013
Practice Address - Street 1:877 JEFFERSON AVE RM 201
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-2807
Practice Address - Country:US
Practice Address - Phone:901-448-4750
Practice Address - Fax:901-448-6013
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5412363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal