Provider Demographics
NPI:1992382774
Name:RUFFIN-JONES, DAMINICA
Entity Type:Individual
Prefix:
First Name:DAMINICA
Middle Name:
Last Name:RUFFIN-JONES
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 1:7712 SADDLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-3044
Mailing Address - Country:US
Mailing Address - Phone:260-572-5095
Mailing Address - Fax:
Practice Address - Street 1:7712 SADDLEWOOD DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-3044
Practice Address - Country:US
Practice Address - Phone:260-572-5095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion