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General NPI Number Information
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NPI Number | 1548505654
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Entity Type | Individual
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Provider Name | AMEENA JEANE RUTLEDGE ALI PHD
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Gender | Female
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Dates
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Enumeration Date | 11/29/2012
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Last Update Date | 12/03/2012
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Provider Practice Location Address
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Address Line | 1719 W AUSTIN RD
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City | DECATUR
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State | GA
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Zip | 30032-4861
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Country | US
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Telephone | 770-870-8045
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Fax | 209-821-8045
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Provider Business Mailing Address
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Address Line | 14238 E MISSISSIPPI PL SUITE 4-205
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City | AURORA
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State | CO
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Zip | 80012-4904
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Country | US
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Telephone | 770-870-8045
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Fax | 209-821-8045
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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