Basic Information
Provider Information
NPI: 1982013686
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOSKINS
FirstName: RUTH
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: F-NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7233 E BASELINE RD STE 126
Address2:  
City: MESA
State: AZ
PostalCode: 852095007
CountryCode: US
TelephoneNumber: 4806992222
FaxNumber: 4806993033
Practice Location
Address1: 7233 E BASELINE RD STE 126
Address2:  
City: MESA
State: AZ
PostalCode: 852095007
CountryCode: US
TelephoneNumber: 4806992222
FaxNumber: 4806993033
Other Information
ProviderEnumerationDate: 08/06/2014
LastUpdateDate: 12/12/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP5760AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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