Provider Demographics
NPI:1437312600
Name:RUTHERFORD, NANCY C (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:C
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:300 E LANCASTER AVE
Mailing Address - Street 2:SUITE 306B
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2139
Mailing Address - Country:US
Mailing Address - Phone:610-664-7793
Mailing Address - Fax:610-664-6667
Practice Address - Street 1:300 E LANCASTER AVE
Practice Address - Street 2:SUITE 306B
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-2139
Practice Address - Country:US
Practice Address - Phone:610-664-7793
Practice Address - Fax:610-664-6667
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN319819L163WP0808X
PATP006882C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health