Provider Demographics
NPI:1285905273
Name:RUTH A DAVIS APN RN FIRST ASSIST LLC
Entity type:Organization
Organization Name:RUTH A DAVIS APN RN FIRST ASSIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:732-278-6038
Mailing Address - Street 1:297 OLD TOMS RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-5935
Mailing Address - Country:US
Mailing Address - Phone:732-278-6038
Mailing Address - Fax:
Practice Address - Street 1:297 OLD TOMS RIVER RD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-5935
Practice Address - Country:US
Practice Address - Phone:732-278-6038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO09589000163WR0006X
NJ26NJ00073800363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty