Healthcare Provider Details

I. General information

NPI: 1871339937
Provider Name (Legal Business Name): KATHRYN RUTLEDGE PATTERSON PA, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN RUTLEDGE PATTERSON KATE PATTERSON

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2173 NORMANDIE DR
MONTGOMERY AL
36111-2728
US

IV. Provider business mailing address

PO BOX 370
FORTSON GA
31808-0370
US

V. Phone/Fax

Practice location:
  • Phone: 334-438-2642
  • Fax: 844-689-4206
Mailing address:
  • Phone: 706-494-3171
  • Fax: 706-221-3132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6822
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: