Individual
REGINA CHANNELL RUFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1923 W GLEN PARK AVE, GRIFFITH, IN 46319-3703
(219) 922-2535
Mailing address
1923 W GLEN PARK AVE, GRIFFITH, IN 46319-3703
(219) 922-2535
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209019415
IL
363LF0000X
Family Nurse Practitioner
Primary
71013320A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209.019415
—
IL
Enumeration date
06/30/2019
Last updated
03/18/2025
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