Provider Demographics
NPI:1912315276
Name:TAYLOR, RUTHANN
Entity Type:Individual
Prefix:MRS
First Name:RUTHANN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:RUTHANN
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:82 STERLING AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-1520
Mailing Address - Country:US
Mailing Address - Phone:570-406-2301
Mailing Address - Fax:
Practice Address - Street 1:613 BALTIMORE DRIVE, SUITE 3
Practice Address - Street 2:HEARTLAND HOSPICE
Practice Address - City:WILKES-BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-7902
Practice Address - Country:US
Practice Address - Phone:866-380-5874
Practice Address - Fax:800-518-4329
Is Sole Proprietor?:No
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013783363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health