1174874432 NPI number — MISS ESTELA A RUIZ MSN, FNP-BC

Table of content: MISS ESTELA A RUIZ MSN, FNP-BC (NPI 1174874432)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174874432 NPI number — MISS ESTELA A RUIZ MSN, FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUIZ
Provider First Name:
ESTELA
Provider Middle Name:
A
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MSN, FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174874432
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/04/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
95-1111 HALEKUA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILILANI
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96789-5518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-429-2156
Provider Business Mailing Address Fax Number:
808-630-2104

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
94-216 FARRINGTON HWY
Provider Second Line Business Practice Location Address:
SUITE B2-105
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797-1922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-853-8870
Provider Business Practice Location Address Fax Number:
808-676-8870
Provider Enumeration Date:
09/27/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  1471 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com