Individual
TASHA RENEE RUTLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PO
Contact information
Practice address
816 W 10TH ST, MEDFORD, OR 97501
(541) 734-5437
(541) 618-1094
Mailing address
816 W 10TH ST, MEDFORD, OR 97501
(541) 734-5437
(541) 618-1094
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
201710258NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201710258NP-PP
—
OR
Enumeration date
01/02/2018
Last updated
04/02/2021
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