Organization
CRADLE TO THE GRAVE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN RUTLEDGE (DIRECTOR)
(601) 947-1330
Entity
Organization
Contact information
Practice address
413 SAINT FRANCIS ST STE B, LEAKESVILLE, MS 39451-8909
(251) 645-4539
(601) 947-1331
Mailing address
PO BOX 1126, LEAKESVILLE, MS 39451-1126
(601) 947-1330
(601) 947-1331
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R875627
MS
Other
Enumeration date
07/03/2016
Last updated
07/03/2016
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