Provider Demographics
NPI:1346284569
Name:ANDERSON, RUTH EMILY (NP)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:EMILY
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 NICOLLET MALL
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2420
Mailing Address - Country:US
Mailing Address - Phone:612-573-2200
Mailing Address - Fax:612-573-2250
Practice Address - Street 1:1221 NICOLLET MALL
Practice Address - Street 2:SUITE 600
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2420
Practice Address - Country:US
Practice Address - Phone:612-573-2200
Practice Address - Fax:612-573-2250
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN0390177-21363LA2200X
MNR 069318-7363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN024999800Medicaid
MN0500004OtherMEDICA PRIMARY
MN132326C029OtherUCARE
MNHP47350OtherHEALTHPARTNERS
MN0408143OtherMEDICA
MN1042079OtherPREFERRED ONE
WI41198800Medicaid
MN84G19ANOtherBCBS OF MN
MN962871042079OtherPREF ONE COM HLTH PLAN
MN2235959OtherAMERICA'S PPO
MT4304315Medicaid
WI41198800Medicaid
MN0500004OtherMEDICA PRIMARY
MNP00200304Medicare ID - Type UnspecifiedRAILROAD MEDICARE