Provider Demographics
NPI:1609680859
Name:DENYANGOS, RUTA C
Entity type:Individual
Prefix:MS
First Name:RUTA
Middle Name:C
Last Name:DENYANGOS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:RUTA
Other - Middle Name:C
Other - Last Name:DENYANGOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3492 LAKE DR SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-4338
Mailing Address - Country:US
Mailing Address - Phone:616-957-4057
Mailing Address - Fax:
Practice Address - Street 1:3492 LAKE DR SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-4338
Practice Address - Country:US
Practice Address - Phone:616-957-4057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3747P1801X3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant