Jennie Petural Ruffin Polk, R.N.

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

RN085179 Issued in LA

Practice address

Department of Preventive Medicine Wamc Stop a
2817 Reilly Rd. MCXC-DPM
Fort Bragg, NC 28310-7301

Phone

(910) 396-7410

Fax

(910) 396-8196

NPI assigned

Apr 4, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1730352311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 REGENCY DR",
            "address_2": "APT. 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283143424",
            "telephone_number": "910-574-7875",
            "fax_number": "910-396-8196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PREVENTIVE MEDICINE WAMC STOP A",
            "address_2": "2817 REILLY RD. MCXC-DPM",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107301",
            "telephone_number": "910-396-7410",
            "fax_number": "910-396-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFIN POLK",
        "first_name": "JENNIE",
        "middle_name": "PETURAL",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "LA",
            "license": "RN085179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashton Rouska
• Larry Leigh Royer Jr., LCSW, BCD
• Philip Jon Royer, DPT
• Nicholas Royster
• Kyle Rudolph, DO
• Micah Rugenstein, PA
• Gregory Rummel, MD
• Rachelle Rush, OTR/L
• Reagan M. Ruska, AUD
• Camethia Pashell Russell, LCSW, MPH, MHA

• Community Health Registered Nurse in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Community Health Registered Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.