Kimberly Amelia Rutland, WHNP

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

78336 Issued in ID

Practice address

810 Sixth Ave
Sandpoint, ID 83864-5396

Phone

(208) 265-6252

Fax

(208) 265-8214

NPI assigned

Jun 28, 2019

Sex

Female

Sole proprietor

No

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 16, 2024.

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1073174199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 SIXTH AVE",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838645396",
            "telephone_number": "208-265-6252",
            "fax_number": "208-265-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 SIXTH AVE",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838645396",
            "telephone_number": "208-265-6252",
            "fax_number": "208-265-8214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLAND",
        "first_name": "KIMBERLY",
        "middle_name": "AMELIA",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "ID",
            "license": "78336",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "WA",
            "license": "AP61044089",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2171876",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Louise Russell, LCSW
• Nicole Elizabeth Russell, MD
• Paige Tara Russell, DNP, NP-C
• Christina Marie Rust, DPT, PA-C
• Robert Edward Rust Jr., M.D.
• Safeway Inc
• Josie Saganski, DC
• Sand Creek Mental Health and Wellness
• Sandcreek Medical Sales & Rentals
• Lori Sanders, LMFT

• All providers in Sandpoint, ID
• Obstetrics & Gynecology Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.