Provider Demographics
NPI:1790843142
Name:DUFFIELD, RUTH ALICIA (FNP0)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ALICIA
Last Name:DUFFIELD
Suffix:
Gender:F
Credentials:FNP0
Other - Prefix:MISS
Other - First Name:RUTH
Other - Middle Name:A
Other - Last Name:STAMPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:360 S GARDEN WAY STE 210
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-8186
Mailing Address - Country:US
Mailing Address - Phone:503-346-0644
Mailing Address - Fax:503-346-0645
Practice Address - Street 1:360 S GARDEN WAY STE 210
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8186
Practice Address - Country:US
Practice Address - Phone:503-494-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201601784NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
R187883OtherMEDICARE