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NPI Code Detail

MEDICARE: CAROL A RUTLEDGE

MEDICARE: CAROL A RUTLEDGE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC0400XCase Management Registered Nurse712619CA

General Provider Information

NPI Number : 1205768694
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL A RUTLEDGE
Provider Business Mailing Address
First Line : 26308 WHISPERING LEAVES DR
Second Line :
City : NEWHALL
State : CA
Zip : 91321-2243
Country : US
Telephone Number : 310-478-3711
Fax Number :
Provider Business Practice Location Address
First Line : 11301 WILSHIRE BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90073-1003
Country : US
Telephone Number : 310-478-3711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ CAROL A RUTLEDGE ” Practice Location

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