1508261413 NPI number — RUTH JOHANNE AUGUSTIN MSN, ARNP, ACNPC-AG

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508261413 NPI number — RUTH JOHANNE AUGUSTIN MSN, ARNP, ACNPC-AG

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AUGUSTIN
Provider First Name:
RUTH
Provider Middle Name:
JOHANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSN, ARNP, ACNPC-AG
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:
1508261413
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 612532
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33261-2532
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-267-7346
Provider Business Mailing Address Fax Number:
866-646-8533

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2020 NE 169TH ST APT 204
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH MIAMI BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33162-3265
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-267-7346
Provider Business Practice Location Address Fax Number:
866-646-8533
Provider Enumeration Date:
11/04/2014

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: 363LA2100X , with the licence number:  C-APN.0003941-C-NP , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2100X , with the licence number: APRNGAA-NP000691 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2100X , with the licence number: 4704393620 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2100X , with the licence number: ARNP9310418 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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