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General NPI Number Information
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NPI Number | 1871243964
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Entity Type | Individual
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Provider Name | KERRY CATHERINE RUTLAND MPA
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Gender | Female
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 175 EATON ST
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City | OAKVILLE
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State | CT
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Zip | 06779-1250
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Country | US
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Telephone | 860-471-2521
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Fax | 860-631-1054
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Provider Business Mailing Address
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Address Line | 175 EATON ST
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City | OAKVILLE
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State | CT
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Zip | 06779-1250
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Country | US
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Telephone | 860-417-2521
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Fax | 860-631-1054
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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