MRS. DEMETRIA LAVETTE WALKER-RUTLEDGE


Address: 10141 Big Bend Rd Ste 101, Riverview, FL 33578
Phone: 8133971270

MRS. DEMETRIA LAVETTE WALKER-RUTLEDGE (NPI# 1821503111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1821503111
Entity Type Individual
Full Name MRS. DEMETRIA LAVETTE WALKER-RUTLEDGE
Credential APRN-C
Practice Address 10141 Big Bend Rd Ste 101
Riverview
FL 33578
Mailing Address Po Box 10744
Clearwater
FL 33757-8744
Practice Telephone 8133971270
Practice Fax Number 8133971271
Mailing Telephone 7275320002
Mailing Fax Number 7272664943
Enumeration Date 2017-12-07
Last Update Date 2019-01-15
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363L00000X Nurse Practitioner 9181104 FL Physician Assistants & Advanced Practice Nursing Providers
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
APRN9181104 FL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL 101700500 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
10141 Big Bend Rd Ste 101, Riverview, FL 335787419 8133971270
301 Shell Manor Dr, Ruskin, FL 335705005 8139667554

Office Location

Street Address 10141 BIG BEND RD STE 101
City RIVERVIEW
State FL
Zip Code 33578

Providers in the same location

NPI Name Taxonomy Address Enumeration
1124482351 Okwudili Okpaleke Family Medicine 10141 Big Bend Rd Ste 101, Riverview, FL 33578-7419 2016-04-13

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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1194247452 Thraese Renata Brown Nurse Practitioner 6901 Simmons Loop Fl 4, Riverview, FL 33578-9498 2017-07-08

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Competitor

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City RIVERVIEW
Zip Code 33578

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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