Provider Demographics
NPI:1508430315
Name:RUFFNER, CARLI (CRNP-PMH)
Entity Type:Individual
Prefix:
First Name:CARLI
Middle Name:
Last Name:RUFFNER
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:CARLI
Other - Middle Name:
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP-PMH
Mailing Address - Street 1:10433 STEVENSON RD STE B
Mailing Address - Street 2:
Mailing Address - City:STEVENSON
Mailing Address - State:MD
Mailing Address - Zip Code:21153-0602
Mailing Address - Country:US
Mailing Address - Phone:443-379-0447
Mailing Address - Fax:443-558-3488
Practice Address - Street 1:10433B STEVENSON RD
Practice Address - Street 2:
Practice Address - City:STEVENSON
Practice Address - State:MD
Practice Address - Zip Code:21153-0602
Practice Address - Country:US
Practice Address - Phone:443-379-0447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR220020163WP0200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0200XNursing Service ProvidersRegistered NursePediatrics