Basic Information
| Provider Information | |||||||||
| NPI: | 1912429770 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUTLAND | ||||||||
| FirstName: | MERIT | ||||||||
| MiddleName: | ISRAEL | ||||||||
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| Credential: | AGNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2260 MORSE RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432295858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6147027899 | ||||||||
| FaxNumber: | 6147061570 | ||||||||
| Practice Location | |||||||||
| Address1: | 2260 MORSE RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432295858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6147027899 | ||||||||
| FaxNumber: | 6147061570 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2017 | ||||||||
| LastUpdateDate: | 12/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | LE00020423 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
No ID Information.