Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | F06211214 | MA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | F06211214 | MA |
NPI | 1023689429 |
---|---|
Provider Name | Ruth Ngeth |
First Address | Lowell, MA 01852-5648 |
Second Address | Lowell, MA 01852-2103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2021 |
Last Update Date | 07/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F06211214 | (05) | MA |