Provider Demographics
NPI:1629471784
Name:RUE, MARIAH (APRN)
Entity Type:Individual
Prefix:MS
First Name:MARIAH
Middle Name:
Last Name:RUE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 ELBERTA AVE SW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-1075
Mailing Address - Country:US
Mailing Address - Phone:330-312-1054
Mailing Address - Fax:
Practice Address - Street 1:7337 CARITAS CIR NW
Practice Address - Street 2:SUITE 150
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-9126
Practice Address - Country:US
Practice Address - Phone:330-478-0001
Practice Address - Fax:330-837-2646
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAG0714168363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAG0714168OtherAANP
OHCOA.16472-NPOtherOHIO BOARD OF NURSING