Provider Demographics
NPI:1255963161
Name:HOOGMOED, RUTH (RN)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:HOOGMOED
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6475 BRIDLEWOOD CT NE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-9664
Mailing Address - Country:US
Mailing Address - Phone:616-682-0578
Mailing Address - Fax:
Practice Address - Street 1:6475 BRIDLEWOOD CT NE
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MI
Practice Address - Zip Code:49301-9664
Practice Address - Country:US
Practice Address - Phone:616-682-0578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-08
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704153578163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health