Individual
HEATHER J RUCCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
950 BRECKENRIDGE LN STE 280, LOUISVILLE, KY 40207-5900
(844) 893-0012
Mailing address
PO BOX 12369, MURFREESBORO, TN 37129-0048
(844) 893-0012
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1054
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100035930
—
KY
Enumeration date
01/10/2008
Last updated
05/22/2025
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