Provider Demographics
NPI:1215774609
Name:RUGGLES, CAROLINE E (PA)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:E
Last Name:RUGGLES
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7199
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4110 OUTPATIENT CIRCLE
Practice Address - Street 2:THIRD FLOOR, SUITE 3150
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-686-6918
Practice Address - Fax:501-686-8960
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARPA-1294363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant