Individual
MS. MARY ELIZABETH RUTHERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, BC
Contact information
Practice address
1820 MEMORIAL DRIVE, SUITE 101, CLARKSVILLE, TN 37043-4693
(931) 553-4161
(931) 553-4161
Mailing address
1820 MEMORIAL DRIVE, SUITE. 101, CLARKSVILLE, TN 37043-4693
(931) 553-4161
(931) 553-4176
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
APRN7209
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARPN7209
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3908530
—
TN
01
—
4104879
BLUE CROSS BLUE SHIELD
TN
Enumeration date
08/25/2006
Last updated
09/07/2010
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