Individual
KELSEY R. RUTHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
10101 PARK ROWE AVE STE 200, BATON ROUGE, LA 70810-1685
(225) 769-2200
(225) 768-2185
Mailing address
10101 PARK ROWE AVE STE 200, BATON ROUGE, LA 70810-1685
(225) 769-2200
(225) 768-2185
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200533
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200533
LICENSE
LA
Enumeration date
08/23/2019
Last updated
08/23/2019
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