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Individual

ANGELA L RUTAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
2231 TIMBER TRL, BELLEFONTAINE, OH 43311-9036
(937) 599-3115
Mailing address
110 DOWELL AVE, BELLEFONTAINE, OH 43311-2305

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.06501
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2285469
OH
01
341407259
AETNA
OH
01
341407259
TRICARE
Enumeration date
06/11/2006
Last updated
12/06/2019
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