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Individual

TINA RUTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
901 PRESTON AVE, SUITE 300, CHARLOTTESVILLE, VA 22903-4491
(434) 977-3140
(434) 977-4984
Mailing address
901 PRESTON AVE, SUITE 300, CHARLOTTESVILLE, VA 22903-4491
(434) 977-3140
(434) 977-4984

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
0024166364
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010134552
VA
Enumeration date
06/03/2006
Last updated
09/29/2015
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