Individual
JEAN H RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12502 WILLOWBROOK RD, STE 380, CUMBERLAND, MD 21502-6592
(240) 964-8585
(240) 964-8586
Mailing address
12502 WILLOWBROOK RD, STE 380, CUMBERLAND, MD 21502-6592
(240) 964-8585
(240) 964-8586
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024166119
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R197967
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010088682
—
VA
01
—
137118
ANTHEM
VA
Enumeration date
03/18/2006
Last updated
01/28/2013
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