Healthcare Provider Details

I. General information

NPI: 1912918517
Provider Name (Legal Business Name): SHARON RUTLEDGE AUD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MOYE BLVD SCHOOL OF ALLIED HEALTH SCIENCES/CSDI
GREENVILLE NC
27834
US

IV. Provider business mailing address

PO BOX 751069
CHARLOTTE NC
28275-1069
US

V. Phone/Fax

Practice location:
  • Phone: 252-744-6099
  • Fax: 252-744-6148
Mailing address:
  • Phone: 252-744-3253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number5381
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: