Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 11121-33 | WI |
NPI | 1003366733 |
---|---|
Provider Name | Naomi Muthoni Ruiru |
First Address | Rochester, MN 55905-0001 |
Second Address | La Crosse, WI 54601-8806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2016 |
Last Update Date | 22/10/2021 |