Provider Demographics
NPI:1376726166
Name:RUTTER, KATHLEEN OLMSTED (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:OLMSTED
Last Name:RUTTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:MARGARET
Other - Last Name:OLMSTED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:9830 E HARMONY LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-6740
Mailing Address - Country:US
Mailing Address - Phone:520-790-8676
Mailing Address - Fax:
Practice Address - Street 1:3601 S 6TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85723-0001
Practice Address - Country:US
Practice Address - Phone:520-792-1450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN082285163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse