Provider Demographics
NPI:1750773719
Name:RUTLEDGE, LAWANDA (RDN, MBA, PHD)
Entity type:Individual
Prefix:DR
First Name:LAWANDA
Middle Name:
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:RDN, MBA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8576 HIGH STONE WAY
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-9337
Mailing Address - Country:US
Mailing Address - Phone:630-660-9340
Mailing Address - Fax:
Practice Address - Street 1:8576 HIGH STONE WAY
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-9337
Practice Address - Country:US
Practice Address - Phone:630-660-9340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic