Provider Demographics
NPI:1558790006
Name:MYERS, RUTH (CNP)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SEAGATE # 800
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1558
Mailing Address - Country:US
Mailing Address - Phone:419-690-7611
Mailing Address - Fax:419-690-7613
Practice Address - Street 1:2751 BAY PARK DR STE 209
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-4922
Practice Address - Country:US
Practice Address - Phone:419-690-7611
Practice Address - Fax:419-690-7613
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001248067363LF0000X
OHCOA.17317-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily