Provider Demographics
NPI:1841541778
Name:RUTHERFORD, LINDA JOY (RN)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:JOY
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 E 65TH ST
Mailing Address - Street 2:STE. 104
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4421
Mailing Address - Country:US
Mailing Address - Phone:912-355-1440
Mailing Address - Fax:912-355-0802
Practice Address - Street 1:835 E 65TH ST
Practice Address - Street 2:STE. 104
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4421
Practice Address - Country:US
Practice Address - Phone:912-355-1440
Practice Address - Fax:912-355-0802
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN211200163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)