Provider Demographics
NPI:1801775994
Name:GADD, RUBYSUE CLEO
Entity type:Individual
Prefix:
First Name:RUBYSUE
Middle Name:CLEO
Last Name:GADD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7088 MARSH CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45426-3124
Mailing Address - Country:US
Mailing Address - Phone:937-718-4682
Mailing Address - Fax:
Practice Address - Street 1:7088 MARSH CREEK DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45426-3124
Practice Address - Country:US
Practice Address - Phone:937-718-4682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant