Provider Demographics
NPI:1770724981
Name:RUEHL, BROOKE DIANE (MS)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:DIANE
Last Name:RUEHL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:DIANE
Other - Last Name:FRENCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:11778 CARMEL CREEK RD
Mailing Address - Street 2:C 305
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-6750
Mailing Address - Country:US
Mailing Address - Phone:760-496-8943
Mailing Address - Fax:
Practice Address - Street 1:BLDG. H 2005 KNIGHT LANE
Practice Address - Street 2:NAVY MEDICINE SUPPORT COMMAND, MEDICAL STAFF SERVICES
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32212-0140
Practice Address - Country:US
Practice Address - Phone:619-532-6460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program