Provider Demographics
NPI:1295811628
Name:GINGERICH, RUTH G (CPNP)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:G
Last Name:GINGERICH
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 223360
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93922-3360
Mailing Address - Country:US
Mailing Address - Phone:831-624-9679
Mailing Address - Fax:831-625-5521
Practice Address - Street 1:25700 CANADA DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8924
Practice Address - Country:US
Practice Address - Phone:831-624-9679
Practice Address - Fax:831-625-5521
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA372084363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP0772810Medicaid