Provider Demographics
NPI:1518543735
Name:RUTTER, KENDRA JO (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:JO
Last Name:RUTTER
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:MS
Other - First Name:KENDRA
Other - Middle Name:JO
Other - Last Name:HANNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:999 GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1330
Mailing Address - Country:US
Mailing Address - Phone:740-454-8193
Mailing Address - Fax:
Practice Address - Street 1:999 GARDEN RD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1330
Practice Address - Country:US
Practice Address - Phone:740-454-8193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028485363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily