Provider Demographics
NPI:1386670156
Name:BROBST, RUTH (MSN CRNP)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:BROBST
Suffix:
Gender:F
Credentials:MSN CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1632
Mailing Address - Country:US
Mailing Address - Phone:610-644-6251
Mailing Address - Fax:610-644-1440
Practice Address - Street 1:11 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301
Practice Address - Country:US
Practice Address - Phone:610-644-6251
Practice Address - Fax:610-644-1440
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP004773B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily