Provider Demographics
NPI:1316427859
Name:RUIZ, SHARON (RRT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 663
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:NC
Mailing Address - Zip Code:28371-0663
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:154 DAVID PARNEL ST
Practice Address - Street 2:
Practice Address - City:PARKTON
Practice Address - State:NC
Practice Address - Zip Code:28371
Practice Address - Country:US
Practice Address - Phone:910-308-6101
Practice Address - Fax:910-239-8285
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5942227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1477079663Medicaid