Ruth Mozell Anderson, REGISTERED NURSE
Individual provider Active NPI Case Management Registered Nurse · Fort Campbell, KY
NPI 1043901358 · NPPES record last updated May 17, 2023
Key facts
- NPI
- 1043901358
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Management Registered Nurse 163WC0400X
- License
- 1058340 (KY)
- Practice address
- 5979 Desert Storm Ave
Fort Campbell, KY 42223-5514 - Phone
- (270) 412-3856
- Fax
- (270) 461-0430
- NPI assigned
- May 17, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1058340 | KY | MD | Case Management Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | 1058340 | KY | Yes |
Addresses
Primary practice location
5979 Desert Storm Ave
Fort Campbell, KY 42223-5514
Mailing address
5979 Desert Storm Ave
Fort Campbell, KY 42223-5514
Phone (270) 412-3856
Other providers in Fort Campbell, KY
- Dominique Anaya
- Krystal Shonne' Anderson-Watts
- Brent Eric Anderson
- Melissa Lou Anderson
- Rita Ann Anderson
- Jessica Andree
- Jamie Nathan Andrews
- Shandra Elaine Andry
- Anthony Patsy Apa
- George Nelson Appenzeller
All providers in Fort Campbell, KY · Case Management Registered Nurse in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.