Provider Demographics
NPI:1639574353
Name:RUFFIN, ANGELINA KIERIN (CNM)
Entity Type:Individual
Prefix:MS
First Name:ANGELINA
Middle Name:KIERIN
Last Name:RUFFIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 GABLES WAY NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3241
Mailing Address - Country:US
Mailing Address - Phone:734-717-9660
Mailing Address - Fax:
Practice Address - Street 1:2719 FELTON DR STE A
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-3603
Practice Address - Country:US
Practice Address - Phone:404-349-2212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN206754367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife