Provider Demographics
NPI:1104458736
Name:RUHM, LANNA LOUISE (LPN)
Entity type:Individual
Prefix:MRS
First Name:LANNA
Middle Name:LOUISE
Last Name:RUHM
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7475 ALVORD RD
Mailing Address - Street 2:
Mailing Address - City:STITTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13469-1101
Mailing Address - Country:US
Mailing Address - Phone:315-327-8631
Mailing Address - Fax:
Practice Address - Street 1:7475 ALVORD RD
Practice Address - Street 2:
Practice Address - City:STITTVILLE
Practice Address - State:NY
Practice Address - Zip Code:13469-1101
Practice Address - Country:US
Practice Address - Phone:315-327-8631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322224164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse