Provider Demographics
NPI:1154163442
Name:SLEEPBIGJOHN
Entity type:Organization
Organization Name:SLEEPBIGJOHN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:RUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:RNA173014
Authorized Official - Phone:856-294-8672
Mailing Address - Street 1:200 INTRACOASTAL PL APT 306
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33469-2314
Mailing Address - Country:US
Mailing Address - Phone:856-294-8672
Mailing Address - Fax:
Practice Address - Street 1:24 HOSPITAL LN
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-1329
Practice Address - Country:US
Practice Address - Phone:207-454-7521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty