Provider Demographics
NPI:1659431732
Name:ROSS, RUTH SUSANNE (RN)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:SUSANNE
Last Name:ROSS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:1804 HAYES ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2504
Mailing Address - Country:US
Mailing Address - Phone:615-341-4911
Mailing Address - Fax:615-341-4919
Practice Address - Street 1:1804 HAYES ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2504
Practice Address - Country:US
Practice Address - Phone:615-341-4911
Practice Address - Fax:615-341-4919
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000029143363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP91018Medicare UPIN