Individual
MRS. CAROLYN MORCOM RUTLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
825 FAIRFAX AVE, 118, NORFOLK, VA 23507-1914
(757) 446-5955
(757) 446-5196
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-5955
(757) 446-5196
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001076754
VA
363LF0000X
Family Nurse Practitioner
Primary
0024076754
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-002 -003
TRICARE/CHAMPUS
VA
05
—
007790929
—
VA
01
—
04017
NC BC/BS
NC
01
—
42485N
SENTARA OPTIMA
VA
05
—
7004017
—
NC
01
—
PAR
VIRGINIA PREMIER HEALTH
VA
Enumeration date
03/01/2006
Last updated
09/16/2014
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