Provider Demographics
NPI:1871994913
Name:RUTLEDGE, ANGELA BELLE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:BELLE
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 N DIXIE AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2521
Mailing Address - Country:US
Mailing Address - Phone:270-737-0678
Mailing Address - Fax:270-769-1535
Practice Address - Street 1:1009 N DIXIE AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2521
Practice Address - Country:US
Practice Address - Phone:270-737-0678
Practice Address - Fax:270-769-1535
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008734363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100362170Medicaid