Provider Demographics
NPI:1295381176
Name:RUHL, CAROLINE (ANP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:RUHL
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 DEFENSE HWY STE 302
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-8926
Mailing Address - Country:US
Mailing Address - Phone:410-449-2060
Mailing Address - Fax:
Practice Address - Street 1:166 DEFENSE HWY STE 302
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-8926
Practice Address - Country:US
Practice Address - Phone:410-449-2060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR218600363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health