Provider Demographics
NPI:1780252197
Name:RUIZ, KARRIE ANN
Entity type:Individual
Prefix:
First Name:KARRIE
Middle Name:ANN
Last Name:RUIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 WHITE RD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-1550
Mailing Address - Country:US
Mailing Address - Phone:419-455-4155
Mailing Address - Fax:
Practice Address - Street 1:1006 WHITE RD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-1550
Practice Address - Country:US
Practice Address - Phone:419-455-4155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-12
Last Update Date:2021-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant