Provider Demographics
NPI:1427879782
Name:RUIZ, MANUEL JR (RN)
Entity type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:
Last Name:RUIZ
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:MANNY
Other - Middle Name:
Other - Last Name:RUIZ
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:9938 TRAINSTATION CIR APT 561
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5728
Mailing Address - Country:US
Mailing Address - Phone:303-704-1543
Mailing Address - Fax:877-747-9662
Practice Address - Street 1:9938 TRAINSTATION CIR APT 561
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5728
Practice Address - Country:US
Practice Address - Phone:303-704-1543
Practice Address - Fax:877-747-9662
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX762849163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management