Provider Demographics
NPI:1790023505
Name:RUTLEDGE, KAREN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6310 JAN LANE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37341-4961
Mailing Address - Country:US
Mailing Address - Phone:731-377-1575
Mailing Address - Fax:
Practice Address - Street 1:6310 JAN LANE DR
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:TN
Practice Address - Zip Code:37341-4961
Practice Address - Country:US
Practice Address - Phone:731-377-1575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1524103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service