Provider Demographics
NPI:1851131809
Name:RUBY, GINA MARIA
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:MARIA
Last Name:RUBY
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 1:213 LORETTA DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-3508
Mailing Address - Country:US
Mailing Address - Phone:937-718-3963
Mailing Address - Fax:
Practice Address - Street 1:213 LORETTA DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-3508
Practice Address - Country:US
Practice Address - Phone:937-718-3963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker