Provider Demographics
NPI:1063940369
Name:SMITH, RUTH (RN, WHNP)
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN, WHNP
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:
Other - Last Name:MCSWINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P. O. BOX 2598, 1125 REDA BLAND EVANS STREET
Mailing Address - Street 2:OWENS-FRANKLIN HEALTH CENTER, PRAIRIE VIEW A&M UNIVERSI
Mailing Address - City:PRAIRIE VIEW
Mailing Address - State:TX
Mailing Address - Zip Code:77446
Mailing Address - Country:US
Mailing Address - Phone:936-261-1410
Mailing Address - Fax:936-857-4999
Practice Address - Street 1:1125 REDA BLAND EVANS STREET
Practice Address - Street 2:OWENS-FRANKLIN HEALTH CENTER, PRAIRIE VIEW A&M UNIVERSI
Practice Address - City:PRAIRIE VIEW
Practice Address - State:TX
Practice Address - Zip Code:77446
Practice Address - Country:US
Practice Address - Phone:936-261-1410
Practice Address - Fax:936-857-4999
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX449277363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health