Individual
MS. JENNIE PETURAL RUFFIN POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
DEPARTMENT OF PREVENTIVE MEDICINE WAMC STOP A, 2817 REILLY RD. MCXC-DPM, FORT BRAGG, NC 28310-7301
(910) 396-7410
(910) 396-8196
Mailing address
528 REGENCY DR, APT. 201, FAYETTEVILLE, NC 28314-3424
(910) 574-7875
(910) 396-8196
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN085179
LA
Other
Enumeration date
04/04/2008
Last updated
04/04/2008
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