Provider Demographics
NPI:1316448806
Name:VORNDRAN, RUTHANN MARIE
Entity type:Individual
Prefix:
First Name:RUTHANN
Middle Name:MARIE
Last Name:VORNDRAN
Suffix:
Gender:F
Credentials:
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 333
Mailing Address - Street 2:
Mailing Address - City:ROSEBUD
Mailing Address - State:TX
Mailing Address - Zip Code:76570-0333
Mailing Address - Country:US
Mailing Address - Phone:254-760-5438
Mailing Address - Fax:
Practice Address - Street 1:315 SOUTH FOURTH ST
Practice Address - Street 2:
Practice Address - City:ROSEBUD
Practice Address - State:TX
Practice Address - Zip Code:76570-7657
Practice Address - Country:US
Practice Address - Phone:254-760-5438
Practice Address - Fax:254-760-5438
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204867164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse