Individual
ANNA RUIZ-GRUWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2275 W BROADWAY ST, SUITE G, IDAHO FALLS, ID 83402-2902
(208) 529-3967
(208) 419-0684
Mailing address
2275 W BROADWAY ST, SUITE G, IDAHO FALLS, ID 83402-2902
(208) 529-3967
(208) 419-0684
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NP-1174A
ID
363LF0000X
Family Nurse Practitioner
NP-1174A
ID
Other
Enumeration date
06/13/2012
Last updated
07/05/2016
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