Individual
KAITLIN MIZE RUFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC, RN
Contact information
Practice address
91 ENTERPRISE DR, ROCKY MOUNT, NC 27804-9590
(252) 451-3100
(252) 937-3108
Mailing address
7755 ACC BLVD, RALEIGH, NC 27617-8631
(919) 482-5711
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
259034
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144741794
—
NC
01
—
19R06
BCBS OF NC
NC
01
—
259034
NC LICENSE
NC
01
—
NCY234A
MEDICARE
NC
Enumeration date
07/05/2017
Last updated
03/08/2019
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