Provider Demographics
NPI:1790444800
Name:RUTHERFORD, ELIZABETH (PA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:2659 COUNTY ROAD 2112
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-4609
Mailing Address - Country:US
Mailing Address - Phone:903-456-6266
Mailing Address - Fax:
Practice Address - Street 1:1901 MEDI PARK DR STE 2050
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2109
Practice Address - Country:US
Practice Address - Phone:806-355-3352
Practice Address - Fax:806-355-5367
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant