Provider Demographics
NPI:1184360646
Name:RUOFF, TAMARA JO (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:JO
Last Name:RUOFF
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:LAUDENKLOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4825 CRESTHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-1236
Mailing Address - Country:US
Mailing Address - Phone:402-649-7240
Mailing Address - Fax:
Practice Address - Street 1:1600 S 48TH ST STE 600
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1299
Practice Address - Country:US
Practice Address - Phone:402-483-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE69995163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse