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General NPI Number Information
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NPI Number | 1629224761
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Entity Type | Individual
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Provider Name | JENNIFER B RUTLEDGE CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/08/2008
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 1000 36TH ST
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City | VERO BEACH
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State | FL
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Zip | 32960-4862
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Country | US
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Telephone | 772-778-9621
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Fax |
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Provider Business Mailing Address
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Address Line | 7150 TANZANITE PL
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City | GRANT VALKARIA
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State | FL
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Zip | 32949-8278
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Country | US
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Telephone | 423-946-4596
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN0000136033
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN11036018
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License Number State | FL
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