Provider Demographics
NPI:1891292686
Name:HUMAN, RUTH (FNP)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:HUMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:
Other - Last Name:BRANDENBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12526 E 131ST ST
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-5904
Mailing Address - Country:US
Mailing Address - Phone:612-730-8031
Mailing Address - Fax:
Practice Address - Street 1:2505 N ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218
Practice Address - Country:US
Practice Address - Phone:317-554-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28187338A163WG0000X
IN71008171A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice