Individual
VIDA MIA RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
63 MAIN ST, 3RD FLOOR, BROCKTON, MA 02301-4042
(508) 559-6699
Mailing address
63 MAIN STREET, 3RD FLOOR, BROCKTON, MA 02301
(508) 559-6699
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
2268111
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN2268111
NURSE MIDWIFERY LICENSE
MA
Enumeration date
03/23/2010
Last updated
12/27/2011
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