Individual
MR. ROGER WAYNE RUTLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
5328 CYPRESS ST, WEST MONROE, LA 71291-7506
(318) 397-3636
(318) 397-3639
Mailing address
239 THORN DRIVE, CALHOUN, LA 71225
(318) 644-1501
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP03572
LA
363L00000X
Nurse Practitioner
RN073699
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1567591
—
LA
Enumeration date
07/12/2006
Last updated
04/07/2010
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