Individual
RUBY WAGA MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1544 SHELDON ST, SAINT PAUL, MN 55108-2331
(651) 646-3091
(651) 646-3124
Mailing address
4633 PARKCLIFF DR, EAGAN, MN 55123-2143
(651) 405-9652
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R 091572-6
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
049536
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
443720900
—
MN
Enumeration date
04/12/2006
Last updated
07/16/2015
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