Basic Information
Provider Information
NPI: 1477083970
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RUEBUSCH
FirstName: ALLYSON
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 700 ACKERMAN RD STE 570
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432021579
CountryCode: US
TelephoneNumber: 6142934925
FaxNumber:  
Practice Location
Address1: 460 W 10TH AVE
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432101240
CountryCode: US
TelephoneNumber: 6142934925
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/15/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100XAPRN.CNP.021391OHN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
363L00000XAPRNCNP021391OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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