Provider Demographics
NPI:1265836639
Name:RUIZ, CYNTHIA ANN (MSN RN FNP-C CCRN)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANN
Last Name:RUIZ
Suffix:
Gender:F
Credentials:MSN RN FNP-C CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 CANYON FRST
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-2887
Mailing Address - Country:US
Mailing Address - Phone:210-454-8042
Mailing Address - Fax:
Practice Address - Street 1:GRANDE RONDE HOSPITAL
Practice Address - Street 2:900 SUNSET DR
Practice Address - City:LA GRANDE, OR 97850
Practice Address - State:OR
Practice Address - Zip Code:97850
Practice Address - Country:US
Practice Address - Phone:210-454-8042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-14
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT011774363LF0000X
TXAP126659363LF0000X
MI4704384093363L00000X
NM53651363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner