Provider Demographics
NPI:1700835519
Name:RUFF, KRISTIE (ARNP)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:RUFF
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KRISTIE
Other - Middle Name:WARD
Other - Last Name:RUFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2345 MORGANTON BLVD SW
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645
Mailing Address - Country:US
Mailing Address - Phone:828-426-8418
Mailing Address - Fax:828-426-8414
Practice Address - Street 1:2345 MORGANTON BLVD SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645
Practice Address - Country:US
Practice Address - Phone:828-426-8418
Practice Address - Fax:828-426-8414
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC75201363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3087484-00Medicaid
FL3087484-00Medicaid
FLP00919527Medicare PIN