Individual
RIKI R RUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
20310 BLUE SAGE PKWY, OMAHA, NE 68130
(402) 559-0111
(402) 559-0112
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1622
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1622
NE LICENSE
NE
Enumeration date
02/01/2012
Last updated
06/26/2018
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