Provider Demographics
NPI:1336587286
Name:NWINYE, RUTH MUTODA (RN)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:MUTODA
Last Name:NWINYE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:RUTH
Other - Middle Name:MUTODA
Other - Last Name:NWINYE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1630 RIGEL ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-2488
Mailing Address - Country:US
Mailing Address - Phone:951-392-6665
Mailing Address - Fax:951-845-4571
Practice Address - Street 1:1630 RIGEL ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-2488
Practice Address - Country:US
Practice Address - Phone:951-392-6665
Practice Address - Fax:951-845-4571
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA722497163W00000X, 163WC1500X, 163WH1000X, 163WM0705X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No171M00000XOther Service ProvidersCase Manager/Care Coordinator