Provider Demographics
NPI:1700689676
Name:RUFFNER, JEAN (RD, LD)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:RUFFNER
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:JEANIE
Other - Middle Name:
Other - Last Name:RUFFNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD, LD
Mailing Address - Street 1:2412 VALLEY GLEN DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2412 VALLEY GLEN DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-6028
Practice Address - Country:US
Practice Address - Phone:214-529-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT87384133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered