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Individual

KALI RENEE RUTHERFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
2707 JACKSBORO PIKE STE 2, JACKSBORO, TN 37757-2752
(423) 437-8576
Mailing address
2055 GATEHOUSE LN, POWELL, TN 37849-6301
(865) 202-3252

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5906
TN
363A00000X
Physician Assistant
Primary

Other

Enumeration date
04/08/2024
Last updated
04/10/2024
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