MEDICARE: MACI JEAN RUTLEDGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372500000X	Chore Provider	163997	NE
2	372600000X	Adult Companion	163997	NE
3	3747P1801X	Personal Care Attendant	163997	NE

General Provider Information

NPI Number	:	1255263240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACI JEAN RUTLEDGE

Provider Business Mailing Address
First Line	:	881 PARRY DR
Second Line	:
City	:	CHADRON
State	:	NE
Zip	:	69337-2729
Country	:	US
Telephone Number	:	308-430-4671
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 Q STREET
Second Line	:	SUITE 101C
City	:	OMAHA
State	:	NE
Zip	:	68114
Country	:	US
Telephone Number	:	308-430-4671
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ MACI JEAN RUTLEDGE ” Practice Location

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