Healthcare Provider Details

I. General information

NPI: 1609081801
Provider Name (Legal Business Name): JAAMI LYNN MCCLELLAN RUTLEDGE DNP, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAAMI LYNN MCCLELLAN DNP, APRN

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 11/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 RIVERSIDE PKWY STE 107
LAWRENCEVILLE GA
30043-5926
US

IV. Provider business mailing address

2000 RIVERSIDE PKWY STE 107
LAWRENCEVILLE GA
30043-5926
US

V. Phone/Fax

Practice location:
  • Phone: 678-878-2950
  • Fax: 678-623-0904
Mailing address:
  • Phone: 678-878-2950
  • Fax: 678-623-0904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberAP30007704
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberAP30007704
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License NumberAP30007704
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License NumberAP30007704
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30007704
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP30007704
License Number StateWA
# 7
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP30007704
License Number StateWA
# 8
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberAP30007704
License Number StateWA
# 9
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN247100
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: