Provider Demographics
NPI:1770962235
Name:RUFFNER, LAWANDA WITT (NP)
Entity type:Individual
Prefix:
First Name:LAWANDA
Middle Name:WITT
Last Name:RUFFNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 OVERLOOK RD STE B
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3319
Mailing Address - Country:US
Mailing Address - Phone:828-438-5788
Mailing Address - Fax:828-333-5360
Practice Address - Street 1:57 HOWARD GAP RD
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:NC
Practice Address - Zip Code:28732
Practice Address - Country:US
Practice Address - Phone:828-483-4330
Practice Address - Fax:828-483-5417
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007856363LA2200X
NC239851363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP3453Medicaid
NC1770962235Medicaid
NC19F0KOtherBCBS NC
NCNCQ228BOtherMEDICARE PTAN