Provider Demographics
NPI:1396266177
Name:RUTLAND, RITA (APRN)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:RUTLAND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 E 4500 S
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3957
Mailing Address - Country:US
Mailing Address - Phone:435-503-8937
Mailing Address - Fax:
Practice Address - Street 1:308 E 4500 S STE 280
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-3975
Practice Address - Country:US
Practice Address - Phone:435-503-8937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5620142-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily