Ruby Straw
Individual provider Active NPI Driver · Little Rock, AR
NPI 1245945351 · NPPES record last updated Jan 23, 2023
Key facts
- NPI
- 1245945351
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 924069729 (AR)
- Practice address
- 44 Berkshire Dr
Little Rock, AR 72204-3535 - Phone
- (501) 687-7285
- NPI assigned
- Jan 23, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 924069729 | AR | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 924069729 | AR | Yes |
Addresses
Primary practice location
44 Berkshire Dr
Little Rock, AR 72204-3535
Mailing address
44 Berkshire Dr
Little Rock, AR 72204-3535
Phone (501) 687-7285
Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 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.