Provider Demographics
NPI:1720043359
Name:REECE, RUTH ELAINE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ELAINE
Last Name:REECE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:RUTH
Other - Middle Name:ELAINE
Other - Last Name:JOHNSON HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:631 CHERRY HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21225
Mailing Address - Country:US
Mailing Address - Phone:410-354-2000
Mailing Address - Fax:410-354-3674
Practice Address - Street 1:631 CHERRY HILL ROAD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225
Practice Address - Country:US
Practice Address - Phone:410-354-2000
Practice Address - Fax:410-354-3674
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR187181363LF0000X
PAUP004761B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA019154460001Medicaid
PA0019154460001Medicaid
PA0019154460001Medicaid
PA019154460001Medicaid
PAS57460Medicare PIN