Provider Demographics
NPI:1629516299
Name:RUTLEDGE, VIRGINIA KATHLEEN (CRNP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:KATHLEEN
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:VIRGINIA
Other - Middle Name:KATHLEEN
Other - Last Name:CHESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 890
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35961-0890
Mailing Address - Country:US
Mailing Address - Phone:256-524-3090
Mailing Address - Fax:256-524-2885
Practice Address - Street 1:52 S VALLEY AVE STE B
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35961-3263
Practice Address - Country:US
Practice Address - Phone:256-524-3090
Practice Address - Fax:256-524-2885
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-03
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-136284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily