Provider Demographics
NPI:1508430315
Name:RUFFNER, CARLI (CRNP-PMH)
Entity type:Individual
Prefix:
First Name:CARLI
Middle Name:
Last Name:RUFFNER
Suffix:
Gender:
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:CARLI
Other - Middle Name:
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP-PMH
Mailing Address - Street 1:7822 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2115
Mailing Address - Country:US
Mailing Address - Phone:800-847-6028
Mailing Address - Fax:800-847-6028
Practice Address - Street 1:7822 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2115
Practice Address - Country:US
Practice Address - Phone:800-847-6028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR220020163WP0200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0200XNursing Service ProvidersRegistered NursePediatrics