Provider Demographics
NPI:1487972337
Name:RUHLAND, BETH M (RN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:M
Last Name:RUHLAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:M
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 ASTER CT
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-7693
Mailing Address - Country:US
Mailing Address - Phone:920-309-2463
Mailing Address - Fax:
Practice Address - Street 1:1000 ASTER CT
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-7693
Practice Address - Country:US
Practice Address - Phone:920-309-2463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-16
Last Update Date:2010-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI171146-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse