Provider Demographics
NPI:1639319114
Name:RUFF, HAZEL LEE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:HAZEL
Middle Name:LEE
Last Name:RUFF
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23607-5542
Mailing Address - Country:US
Mailing Address - Phone:757-245-0529
Mailing Address - Fax:
Practice Address - Street 1:317 RIP RAP RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-3030
Practice Address - Country:US
Practice Address - Phone:757-723-0648
Practice Address - Fax:757-723-0649
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166077363LF0000X
VA0017138086363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily