Provider Demographics
NPI:1235776311
Name:RUTHERFORD, HAILEE ELIZABETH
Entity type:Individual
Prefix:
First Name:HAILEE
Middle Name:ELIZABETH
Last Name:RUTHERFORD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 AIRPORT RD STE D
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-8184
Mailing Address - Country:US
Mailing Address - Phone:501-547-5718
Mailing Address - Fax:501-625-7777
Practice Address - Street 1:1706 HIGHWAY 71 N
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-8917
Practice Address - Country:US
Practice Address - Phone:479-394-1500
Practice Address - Fax:479-394-1525
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-08
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR122665363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily