Provider Demographics
NPI:1902850464
Name:ZEBROSKI, RUTH C (WHNP)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:C
Last Name:ZEBROSKI
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-2657
Mailing Address - Country:US
Mailing Address - Phone:307-332-2223
Mailing Address - Fax:
Practice Address - Street 1:1460 MAIN ST
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-2657
Practice Address - Country:US
Practice Address - Phone:307-332-2223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY9192.0137363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY113145100Medicaid
WY113145100Medicaid
WYS30970Medicare UPIN