Provider Demographics
NPI:1326241852
Name:CHAZA-NDLOVU, RUTH A (CNP)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:A
Last Name:CHAZA-NDLOVU
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MRS
Other - First Name:RUTH
Other - Middle Name:A
Other - Last Name:CHAZA-NDLOVU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 746071
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6071
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:773-866-8014
Practice Address - Street 1:16888 HARVARD AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-2208
Practice Address - Country:US
Practice Address - Phone:216-682-7703
Practice Address - Fax:216-236-7768
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN332159163W00000X
OHCOA.18168-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse