Provider Demographics
NPI:1871038927
Name:RUTH WINGEIER, CNM, LLC
Entity Type:Organization
Organization Name:RUTH WINGEIER, CNM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSE-MIDWIFE, OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WINGEIER
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:320-874-0768
Mailing Address - Street 1:13 2ND ST N
Mailing Address - Street 2:
Mailing Address - City:LONG PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:56347-1117
Mailing Address - Country:US
Mailing Address - Phone:320-732-8162
Mailing Address - Fax:320-732-8161
Practice Address - Street 1:13 2ND ST N
Practice Address - Street 2:
Practice Address - City:LONG PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:56347-1117
Practice Address - Country:US
Practice Address - Phone:320-732-8162
Practice Address - Fax:320-732-8161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR911869367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN637740800Medicaid