Individual
MYSTIQUE SHAVONNE RUTLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
796 LOG CABIN DR, GASTONIA, NC 28054-0215
(980) 267-7717
Mailing address
796 LOG CABIN DR, GASTONIA, NC 28054-0215
(980) 267-7717
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
HC7837
NC
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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