Provider Demographics
NPI:1841880465
Name:KRIEG, RUTH A
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:A
Last Name:KRIEG
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 1:5618 OHIO INDIANA STATE LINE RD
Mailing Address - Street 2:
Mailing Address - City:FORT RECOVERY
Mailing Address - State:OH
Mailing Address - Zip Code:45846-9403
Mailing Address - Country:US
Mailing Address - Phone:614-404-7202
Mailing Address - Fax:
Practice Address - Street 1:68 E STAR RD
Practice Address - Street 2:
Practice Address - City:ROSSBURG
Practice Address - State:OH
Practice Address - Zip Code:45362-9706
Practice Address - Country:US
Practice Address - Phone:419-336-5301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0254881Medicaid