Provider Demographics
NPI:1295512176
Name:RULLO, GINA M (RN)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:M
Last Name:RULLO
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 1:3309 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-4203
Mailing Address - Country:US
Mailing Address - Phone:412-608-6628
Mailing Address - Fax:
Practice Address - Street 1:4201 WALNUT ST STE 1
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-7300
Practice Address - Country:US
Practice Address - Phone:412-737-5066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN611795163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse