Healthcare Provider Details

I. General information

NPI: 1285350926
Provider Name (Legal Business Name): MORGAN RUTTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2022
Last Update Date: 10/14/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BROOKLINE AVE
BOSTON MA
02215-5450
US

IV. Provider business mailing address

81 CAUSEWAY RD
READING MA
01867-1515
US

V. Phone/Fax

Practice location:
  • Phone: 617-632-3800
  • Fax:
Mailing address:
  • Phone: 603-361-3463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2308800
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: