Basic Information
Provider Information
NPI: 1790155745
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AYALA
FirstName: RUTH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13400 E SHEA BLVD
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852595499
CountryCode: US
TelephoneNumber: 4803018000
FaxNumber:  
Practice Location
Address1: 13400 E SHEA BLVD
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852595452
CountryCode: US
TelephoneNumber: 4803018000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/02/2015
LastUpdateDate: 11/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X903350MSN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363L00000XAP7848AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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