Healthcare Provider Details

I. General information

NPI: 1639006984
Provider Name (Legal Business Name): LAURA LYNN RUTLEDGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 FISHERMAN RD NW
CARROLLTON OH
44615-9071
US

IV. Provider business mailing address

207 FISHERMAN RD NW
CARROLLTON OH
44615-9071
US

V. Phone/Fax

Practice location:
  • Phone: 330-243-0201
  • Fax:
Mailing address:
  • Phone: 330-243-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: