Provider Demographics
NPI:1669047932
Name:DERUWE, ROSEMARIE RUTH (RN)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:RUTH
Last Name:DERUWE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ROSEMARIE
Other - Middle Name:RUTH
Other - Last Name:STOKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8180 W 4TH AVE APT N206
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7523
Mailing Address - Country:US
Mailing Address - Phone:509-520-2601
Mailing Address - Fax:
Practice Address - Street 1:8180 W 4TH AVE APT N206
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7523
Practice Address - Country:US
Practice Address - Phone:509-520-2601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00120425163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse