MS. JENNIE PETURAL RUFFIN POLK (NPI# 1730352311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730352311 |
Entity Type | Individual |
Full Name | MS. JENNIE PETURAL RUFFIN POLK |
Credential | R.N. |
Practice Address |
Department of Preventive Medicine Wamc Stop A 2817 Reilly Rd. Mcxc-dpm Fort Bragg NC 28310-7301 |
Mailing Address |
528 Regency Dr Apt. 201 Fayetteville NC 28314-3424 |
Practice Telephone | 9103967410 |
Practice Fax Number | 9103968196 |
Mailing Telephone | 9105747875 |
Mailing Fax Number | 9103968196 |
Enumeration Date | 2008-04-04 |
Last Update Date | 2008-04-04 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WC1500X |
Registered Nurse Specialization: Community Health |
RN085179 | LA | Nursing Service Providers |
Street Address |
DEPARTMENT OF PREVENTIVE MEDICINE WAMC STOP A 2817 REILLY RD. MCXC-DPM |
City | FORT BRAGG |
State | NC |
Zip Code | 28310-7301 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013550763 | Brent Francis Bachman | Physician Assistant | 2817 Reilly Street, Fort Bragg, NC 28310 | 2019-10-25 |
1417503459 | Cooper Pasque | Dentist | 1838 Normandy Dr., Fort Bragg, Apo, AA 28310 | 2019-08-15 |
1851959951 | Daniel Jordan Whitaker | Student in an Organized Health Care Education/Training Program | Womack Army Medical Center, 2817 Reilly Road, Mcxc-cod Credentials, Fort Bragg, NC 28310 | 2019-06-03 |
1679054217 | Christopher Cetnar | Dentist | Smokebomb Hill, Bldg 3718 Gruber Road, Fort Bragg, NC 28310 | 2018-08-22 |
1316427107 | Alexandrea Lee Clark | Dentist | Laflamme Dental Clinic, Bldg C6238 Ardennes Road, Fort Bragg, NC 28310 | 2018-08-21 |
1457843831 | Kevin Patrick Hudson | Student in an Organized Health Care Education/Training Program | 2817 Reilly Road Mxcx - Cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310 | 2018-06-01 |
1639691462 | Margaret S Greene | Dentist | Usa Dental Health Activity Fort Bragg, Wamc Box #151 2817 Rielly Rd, Fort Bragg, NC 28310 | 2017-07-13 |
1912432246 | Chezdan Baker | Student in an Organized Health Care Education/Training Program | Us Army Dental Health Activity Bldg-6837 Normandy Drive, Fort Bragg, NC 28310 | 2017-04-24 |
1215483094 | Shantryce Monique Boatwright Crump | Dental Hygienist | 2617 Rielly Road, Fort Bragg, NC 28310 | 2016-08-31 |
1629435714 | John Gagnier | Physician Assistant | Gruber Road, Building #c-1722, Fort Bragg, NC 28310 | 2016-01-21 |
Find all providers in zip 28310 |
Taxonomy Code | 163WC1500X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | Community Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144408956 | David L Carden | Registered Nurse | 7 Donelson St, Fort Bragg, NC 28307-2052 | 2008-02-04 |
1487610085 | Karen Marie Goepfrich | Registered Nurse | Womack Army Medical Center / Wellness Center, Building 4-2817 Reilly Rd, Fort Bragg, NC 28310-0001 | 2006-04-22 |
1639134729 | Michael Anthony Barton | Registered Nurse | 2539 Hamilton Street, Preventive Medicine Bldg 2539, Fort Bragg, NC 28310 | 2006-04-20 |
1104881267 | Janice Marie Leslie | Registered Nurse | Bldg 4-2817 Reilly Rd, Fort Bragg, NC 28310-0001 | 2006-04-19 |
1518191600 | Samantha E Bazan | Registered Nurse | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2009-05-05 |
1962668350 | Brigitte Yvette Polk | Registered Nurse | Womack Army Medical Ctr, Fort Bragg, NC 28310-0001 | 2008-08-05 |
1770617383 | Teresa I Hall | Registered Nurse | 2817 Reilly Rd Mcxc-cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310-0001 | 2007-03-15 |
1780719674 | Frederick Nathaniel Dwarica | Registered Nurse | 2817 Reilly Road Mcxc-cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310-0001 | 2007-02-22 |
1447288774 | Leonard Monahan Martinez | Registered Nurse | 2817 Reilly Road Mcxc Cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310 | 2006-06-28 |
1538125208 | Lona Jones | Registered Nurse | 2817 Reilly Rd, Fort Bragg, NC 28310-7324 | 2006-04-21 |
Find all providers in FORT BRAGG |
City | FORT BRAGG |
Zip Code | 28310 |
Please comment or provide details below to improve the information on MS. JENNIE PETURAL RUFFIN POLK.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.