Provider Demographics
NPI:1477538643
Name:ERDMANN, RUTH ANNE (MSCCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ANNE
Last Name:ERDMANN
Suffix:
Gender:F
Credentials:MSCCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4196 157TH ST W
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-4600
Mailing Address - Country:US
Mailing Address - Phone:651-322-7279
Mailing Address - Fax:
Practice Address - Street 1:10721 SMETANA RD
Practice Address - Street 2:SUITE 220
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-8080
Practice Address - Country:US
Practice Address - Phone:952-936-9215
Practice Address - Fax:952-936-9942
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6039235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN840S9RUOtherBCBS
MNHP34798OtherHEALTHPARTNERS
MN4600553OtherMEDICA