Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | RN282487 | GA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN282487 | GA |
NPI | 1497378822 |
---|---|
Provider Name | Ashton Laurel Ruff |
First Address | Colbert, GA 30628-2570 |
Second Address | Morehead City, NC 28557-4510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2020 |
Last Update Date | 20/05/2020 |