Provider Demographics
NPI:1992181820
Name:RUIZ, IRMA G (FNP)
Entity Type:Individual
Prefix:
First Name:IRMA
Middle Name:G
Last Name:RUIZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15255 N 40TH ST
Mailing Address - Street 2:SUITE 127
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4624
Mailing Address - Country:US
Mailing Address - Phone:602-253-0855
Mailing Address - Fax:602-253-0535
Practice Address - Street 1:15255 N 40TH ST
Practice Address - Street 2:SUITE 127
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4624
Practice Address - Country:US
Practice Address - Phone:602-253-0855
Practice Address - Fax:602-253-0535
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8001363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily