Provider Demographics
NPI:1609081801
Name:RUTLEDGE, JAAMI LYNN MCCLELLAN (DNP, ARNP)
Entity Type:Individual
Prefix:
First Name:JAAMI
Middle Name:LYNN MCCLELLAN
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:JAAMI
Other - Middle Name:LYNN
Other - Last Name:MCCLELLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, APRN
Mailing Address - Street 1:2000 RIVERSIDE PKWY STE 107
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-5926
Mailing Address - Country:US
Mailing Address - Phone:678-878-2950
Mailing Address - Fax:678-623-0904
Practice Address - Street 1:2000 RIVERSIDE PKWY STE 107
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5926
Practice Address - Country:US
Practice Address - Phone:678-878-2950
Practice Address - Fax:678-623-0904
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007704163W00000X, 163WG0000X, 163WR0400X, 163WX0106X, 363L00000X, 363LA2200X, 363LP2300X, 363LX0106X
GARN247100363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WX0106XNursing Service ProvidersRegistered NurseOccupational Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health