Provider Demographics
NPI:1881842771
Name:KELLEY, RUTH (RN)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:KELLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RT 1 BOX 55
Mailing Address - Street 2:CLAYLICK ROAD
Mailing Address - City:RIPLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25271
Mailing Address - Country:US
Mailing Address - Phone:304-372-2848
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 55
Practice Address - Street 2:CLAYLICK ROAD
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-9709
Practice Address - Country:US
Practice Address - Phone:304-372-2848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other