Provider Demographics
NPI:1376113720
Name:MOREHEAD-RUFF, LATOYA (BSN MA)
Entity Type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:
Last Name:MOREHEAD-RUFF
Suffix:
Gender:F
Credentials:BSN MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5421 W VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85035-1814
Mailing Address - Country:US
Mailing Address - Phone:623-521-4900
Mailing Address - Fax:
Practice Address - Street 1:5421 W VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85035-1814
Practice Address - Country:US
Practice Address - Phone:623-521-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ376K00000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's Aide