Provider Demographics
NPI:1184792426
Name:HEATH, RUTH ELAINE (LPN)
Entity type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ELAINE
Last Name:HEATH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8596 MILL ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTON
Mailing Address - State:NY
Mailing Address - Zip Code:14138-9763
Mailing Address - Country:US
Mailing Address - Phone:716-988-3827
Mailing Address - Fax:
Practice Address - Street 1:2250 WEHRLE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7037
Practice Address - Country:US
Practice Address - Phone:716-276-2123
Practice Address - Fax:716-276-2129
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113522164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse