Barbara Izabela Rutkowski, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

243853 Issued in AZ

Practice address

155 W Combs Rd
San Tan Valley, AZ 85140-9108

Phone

(480) 474-6620

NPI assigned

Jul 7, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1629696638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143108",
            "telephone_number": "615-425-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W COMBS RD",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851409108",
            "telephone_number": "480-474-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTKOWSKI",
        "first_name": "BARBARA",
        "middle_name": "IZABELA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "243853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.