Provider Demographics
NPI:1902866023
Name:DAVIS, RUTH A (APNC)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:A
Last Name:DAVIS
Suffix:
Gender:F
Credentials:APNC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:297 OLD TOMS RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-5935
Mailing Address - Country:US
Mailing Address - Phone:732-477-7362
Mailing Address - Fax:
Practice Address - Street 1:1944 RTE 33
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4863
Practice Address - Country:US
Practice Address - Phone:732-776-4622
Practice Address - Fax:732-776-3765
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00073800363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health