Provider Demographics
NPI:1598139339
Name:RUTHERFORD, ANNIE LOUISE (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:ANNIE
Middle Name:LOUISE
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MRS
Other - First Name:ANDI
Other - Middle Name:LOUISE
Other - Last Name:RUTHERFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:3505 W 112TH CIR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-7166
Mailing Address - Country:US
Mailing Address - Phone:303-328-5946
Mailing Address - Fax:
Practice Address - Street 1:2045 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5437
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0187131163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse