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General NPI Number Information
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NPI Number | 1659026474
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Entity Type | Individual
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Provider Name | HANNAH MARIE RUTKOWSKI
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Gender | Female
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Dates
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Enumeration Date | 02/21/2022
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 36000 EUCLID AVE
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City | WILLOUGHBY
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State | OH
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Zip | 44094-4625
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Country | US
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Telephone | 440-953-1953
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Fax |
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Provider Business Mailing Address
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Address Line | 6502 SOUTHGROVE RD
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City | MENTOR
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State | OH
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Zip | 44060-3450
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Country | US
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Telephone | 440-725-8546
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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