Individual
BRENNA ADEN RUTHERFORD
Active
Individual
BRENNA ADEN RUTHERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10947
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1098260
PA LICENSURE - NCCPA
MN
Enumeration date
06/11/2011
Last updated
11/02/2023
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