MS. JENNIE PETURAL RUFFIN POLK


Address: Department of Preventive Medicine Wamc Stop A, 2817 Reilly Rd. Mcxc-dpm, Fort Bragg, NC 28310-7301
Phone: 9103967410

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WC1500X Registered Nurse
Specialization: Community Health
RN085179 LA Nursing Service Providers

Office Location

Street Address DEPARTMENT OF PREVENTIVE MEDICINE WAMC STOP A
2817 REILLY RD. MCXC-DPM
City FORT BRAGG
State NC
Zip Code 28310-7301

Providers in the same zip code

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 Information

Taxonomy Code 163WC1500X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Community Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Competitor

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City FORT BRAGG
Zip Code 28310

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Dataset Information

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.

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