Individual
LISA ANN RUBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 418-2600
Mailing address
3400 S BROADWAY, MINOT, ND 58701-7420
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L16972
ND
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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