Provider Demographics
NPI:1386766574
Name:KRIZ, RUTH (APRN)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:KRIZ
Suffix:
Gender:F
Credentials:APRN
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 2445
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-0445
Mailing Address - Country:US
Mailing Address - Phone:202-714-2415
Mailing Address - Fax:703-877-0714
Practice Address - Street 1:2604 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-1547
Practice Address - Country:US
Practice Address - Phone:202-714-2415
Practice Address - Fax:703-698-9238
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1005391363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner