Provider Demographics
NPI:1851451694
Name:SEPPALA, RUTH (RN, MSN, FNP)
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:
Last Name:SEPPALA
Suffix:
Gender:F
Credentials:RN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5055 E BROADWAY BLVD STE A100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3629
Mailing Address - Country:US
Mailing Address - Phone:520-795-4783
Mailing Address - Fax:520-547-5797
Practice Address - Street 1:2155 W ORANGE GROVE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3118
Practice Address - Country:US
Practice Address - Phone:520-742-0414
Practice Address - Fax:520-742-6635
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1291363LF0000X
AZRN101345363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z61788OtherMEDICARE
AZ198535Medicaid
ZFQ31815OtherMEDICARE
Z140517OtherMEDICARE
03-1828OtherMEDICARE