Provider Demographics
NPI:1386980712
Name:RUFFIN, KAYLA MONAE (LPN)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MONAE
Last Name:RUFFIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4064 E 144TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-1863
Mailing Address - Country:US
Mailing Address - Phone:216-205-3366
Mailing Address - Fax:
Practice Address - Street 1:4064 E 144TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-1863
Practice Address - Country:US
Practice Address - Phone:216-205-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.151409-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH151409OtherOHIO BOARD OF NURSING