Erica Ruffin
Individual provider Active NPI Clinic/Center · Bossier, LA
NPI 1922847656 · NPPES record last updated May 22, 2024
Key facts
- NPI
- 1922847656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinic/Center 261Q00000X
- Practice address
- 2750 Shed Rd D2
Bossier, LA 71067 - Phone
- (318) 412-6720
- Fax
- (318) 230-7788
- NPI assigned
- May 22, 2024
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
2750 Shed Rd D2
Bossier, LA 71067
Mailing address
2750 Shed Rd Ste D2
Bossier City, LA 71111-3386
Phone (318) 412-6720
Other providers in Bossier, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2024. 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.