Provider Demographics
NPI:1184408262
Name:RUTLEDGE, LELAND ELAINE
Entity type:Individual
Prefix:
First Name:LELAND
Middle Name:ELAINE
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2069 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3830
Mailing Address - Country:US
Mailing Address - Phone:216-496-5575
Mailing Address - Fax:
Practice Address - Street 1:2069 W 38TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-3830
Practice Address - Country:US
Practice Address - Phone:216-496-5575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider