LAURA H RUTLEDGE RN, APN, NPI 1578566469 — PHOENIX (AZ)

NPI 1578566469

14+ Years Experience Individual

LAURA H RUTLEDGE RN, APN

05/24/2005
PROVIDER ENUMERATION DATE
12/23/2008
LAST UPDATE DATE
1578566469
NPI NUMBER

About LAURA H RUTLEDGE

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

LAURA H RUTLEDGE is a provider established in PHOENIX, AZ. The NPI number of LAURA H RUTLEDGE is 1578566469 and was assigned on 05/24/2005. The practitioners primary taxonomy code is: 363LW0102X with license number: AP2692 AZ .

Mailing address

  • City: PHOENIX
  • State: AZ
  • Postal code: 850163911
  • Phone: 6022411671
  • Fax: 6022307982
  • Address: 1661 E CAMELBACK RD
  • Address 2: SUITE 160

Primary Practice Address

  • Region : PHOENIX, AZ
  • NPI : 1578566469
  • Phone : 4807599191
  • Fax : 4807599105
  • Postalcode : 850446094
  • Address : 4530 E RAY RD SUITE 172

Provider taxonomy - Nurse Practitioner

  • Taxonomy code: 363LW0102X
  • License number: AP2692
  • License state: AZ

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • LAURA H RUTLEDGE RN, APN
  • Address : 4530 E RAY RD SUITE 172
  • Region : PHOENIX, AZ
  • NPI : 1578566469
  • Phone : 4807599191
  • Fax : 4807599105
  • Postalcode : 850446094

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address4530 E RAY RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE 172
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePHOENIX
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameAZ
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code850446094
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number4807599191
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number4807599105
The fax number associated with the location address of the provider being identified.
NPI1578566469
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1363LW0102X
Provider Enumeration Date05/24/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated12/23/2008
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)LAURA H RUTLEDGE
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address1661 E CAMELBACK RD
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE 160
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NamePHOENIX
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameAZ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code850163911
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6022411671
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number6022307982
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1363LW0102X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Nurse Practitioner
Provider License Number 1AP2692
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1AZ
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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