Provider Demographics
NPI:1831208495
Name:RUIZ-PERDOMO, YANIRA C (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:YANIRA
Middle Name:C
Last Name:RUIZ-PERDOMO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14427 BLACK HORSE CT
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-2835
Mailing Address - Country:US
Mailing Address - Phone:703-371-0805
Mailing Address - Fax:
Practice Address - Street 1:NIH NIAMS COMMUNITY HEALTH CLINIC
Practice Address - Street 2:10 CENTER DRIVE, BLDG 10, RM 6N216
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-451-0033
Practice Address - Fax:202-673-0012
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001127160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily