Ruffin, Regina Channell

Ruffin, Regina Channell is an individual health care provider with primary practice located at 1923 W Glen Park Ave , Griffith IN 46319-3703. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Ruffin, Regina Channell can be contacted via phone (219) 922-2535.

Contact Information

Primary practice address
1923 W Glen Park Ave Griffith IN 46319-3703
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209019415 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71013320A Indiana

Profile Details

NPI number 1164084133
LBN Legal business name Ruffin, Regina Channell
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2019
Last updated Dec 12th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164084133 NPPES
Illinois MEDICAID 209.019415

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