Provider Demographics
NPI:1578152187
Name:JEUNE, RUTH
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:
Last Name:JEUNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:
Other - Last Name:JEUNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3646 HUDSON LN
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-8551
Mailing Address - Country:US
Mailing Address - Phone:786-278-4303
Mailing Address - Fax:
Practice Address - Street 1:3646 HUDSON LN
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-8551
Practice Address - Country:US
Practice Address - Phone:786-278-4303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9503116163WC0400X
253Z00000X, 261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No253Z00000XAgenciesIn Home Supportive Care