Individual
STACEY NICOLE RUTLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 W LIBERTY ST, FARMINGTON, MO 63640-1921
(573) 756-6451
Mailing address
6027 KENSINGTON WAY, IMPERIAL, MO 63052-2369
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2026014054
MO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/05/2025
Last updated
03/30/2026
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