Provider Demographics
NPI:1386203842
Name:RUIZ, KIRSTIN CAYCE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KIRSTIN
Middle Name:CAYCE
Last Name:RUIZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KIRSTIN
Other - Middle Name:ARIEL
Other - Last Name:CAYCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1318A W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3326
Mailing Address - Country:US
Mailing Address - Phone:214-222-0781
Mailing Address - Fax:214-222-0769
Practice Address - Street 1:4115 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76103-3614
Practice Address - Country:US
Practice Address - Phone:817-796-7370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141813363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily