Provider Demographics
NPI:1689726648
Name:RUTLEDGE, ALLYSON TORRENCE (RD LDN)
Entity Type:Individual
Prefix:MRS
First Name:ALLYSON
Middle Name:TORRENCE
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:
Other - First Name:ALLYSON
Other - Middle Name:LYNN
Other - Last Name:TORRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19809 B NORTH COVE ROAD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031
Mailing Address - Country:US
Mailing Address - Phone:704-895-9865
Mailing Address - Fax:704-895-9870
Practice Address - Street 1:16501 D NORTHCROSS DRIVE
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078
Practice Address - Country:US
Practice Address - Phone:704-895-9865
Practice Address - Fax:704-895-9870
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL001415133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered