| Doctor Name: | MRS. JENNIFER CARRUTH |
| NPI Number: | 1033408331 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, NP-C |
| License Number: | RN178859 |
| Business Practice Address: | 2782 N Cobb Pkwy Kennesaw, GA - 301523472 |
| Business Phone Number: | 7704201092 |
| Business Fax Number: | |
| Mailing Address: | 472 Bottesford Dr Nw, KENNESAW |
| State: | GA |
| Postal Code: | 301447129 |
| Phone Number: | 2692746294 |
| Fax Number: | |
| NPI Enumeration Date: | 04/07/2011 |
| NPI Last Update Date: | 01/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN178859 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |