Provider Demographics
NPI:1942247259
Name:BOOKER, RUTH ELAINE
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ELAINE
Last Name:BOOKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4845 MEADOWVISTA DR
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-1912
Mailing Address - Country:US
Mailing Address - Phone:937-235-2725
Mailing Address - Fax:
Practice Address - Street 1:4845 MEADOWVISTA DR
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-1912
Practice Address - Country:US
Practice Address - Phone:937-235-2725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2085247374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2085247Medicaid