Provider Demographics
NPI:1356890636
Name:NEBORSKY, RUTH ANNE (APRN)
Entity type:Individual
Prefix:
First Name:RUTH ANNE
Middle Name:
Last Name:NEBORSKY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2364 VICTORY HL
Mailing Address - Street 2:
Mailing Address - City:VICTORY
Mailing Address - State:VT
Mailing Address - Zip Code:05858-7042
Mailing Address - Country:US
Mailing Address - Phone:802-751-9740
Mailing Address - Fax:
Practice Address - Street 1:2364 VICTORY HL
Practice Address - Street 2:
Practice Address - City:VICTORY
Practice Address - State:VT
Practice Address - Zip Code:05858-7042
Practice Address - Country:US
Practice Address - Phone:802-751-9740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA186171363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care