Provider Demographics
NPI:1619238110
Name:RUFFINWILSON, FLORIAN (RN)
Entity Type:Individual
Prefix:
First Name:FLORIAN
Middle Name:
Last Name:RUFFINWILSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5455 N MARGINAL RD APT 121
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-3938
Mailing Address - Country:US
Mailing Address - Phone:216-432-9868
Mailing Address - Fax:
Practice Address - Street 1:5455 N MARGINAL RD APT 121
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-3938
Practice Address - Country:US
Practice Address - Phone:216-432-9868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH147166163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse