Provider Demographics
NPI:1437570504
Name:KING, LEANNE RUTLEDGE (NP)
Entity Type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:RUTLEDGE
Last Name:KING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1895 HOFFMAN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-6557
Mailing Address - Country:US
Mailing Address - Phone:704-861-8669
Mailing Address - Fax:704-865-5081
Practice Address - Street 1:1895 HOFFMAN RD
Practice Address - Street 2:SUITE B
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-6557
Practice Address - Country:US
Practice Address - Phone:704-861-8669
Practice Address - Fax:704-865-5081
Is Sole Proprietor?:No
Enumeration Date:2013-12-17
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC167997207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine