Provider Demographics
NPI:1023098035
Name:RUTLEDGE, CATHERINE V (CRNA)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:V
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:L
Other - Last Name:ALLARDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 235022
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36123-5022
Mailing Address - Country:US
Mailing Address - Phone:334-386-2051
Mailing Address - Fax:334-396-6929
Practice Address - Street 1:1000 1ST ST N
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8703
Practice Address - Country:US
Practice Address - Phone:205-620-8948
Practice Address - Fax:205-620-7032
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1084045367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051553646Medicaid
AL051553646Medicare ID - Type Unspecified
AL051553646Medicaid