Provider Demographics
NPI:1750600870
Name:RUGGLES, WILLIAM ANDREW (APRN)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ANDREW
Last Name:RUGGLES
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:137 STATE ROUTE 3117
Mailing Address - Street 2:
Mailing Address - City:SOUTH SHORE
Mailing Address - State:KY
Mailing Address - Zip Code:41175-9597
Mailing Address - Country:US
Mailing Address - Phone:606-932-2079
Mailing Address - Fax:606-932-2313
Practice Address - Street 1:137 STATE ROUTE 3117
Practice Address - Street 2:
Practice Address - City:SOUTH SHORE
Practice Address - State:KY
Practice Address - Zip Code:41175
Practice Address - Country:US
Practice Address - Phone:606-932-2079
Practice Address - Fax:606-932-2313
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH3273051363LP0200X
KY3006477363LP0200X, 363L00000X
OH11818363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3006477OtherAPRN
OH11818OtherNP
OH3122730Medicaid
KY000000679664OtherANTHEM BCBS
KY7100122840Medicaid
KY7100373950Medicaid