Renee N. Rutherford, PA-C

Physician Assistant · O Fallon, IL

Individual Active NPI

NPI number 1619166345

Practice location

916 Talon Dr
Suite 102
O Fallon, IL 62269-1848
Phone
(618) 628-8211
Fax
(618) 628-0883

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NPI record

NPI
1619166345
Entity type
Individual (Type 1)
Enumeration date
October 18, 2007
Last updated
August 21, 2008
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 085-003107 IL

About Renee Rutherford

Renee N. Rutherford, PA-C is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 916 Talon Dr, Suite 102, O Fallon, IL 62269-1848. The NPI number 1619166345 was assigned on October 18, 2007 and the record was last updated on August 21, 2008.

Renee Rutherford lists a license in the registry: #085-003107 (IL) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Renee N. Rutherford, PA-C?

The NPI number is 1619166345.

What is the phone number of Renee Rutherford?

The phone number listed for the practice location is (618) 628-8211.

Where is Renee Rutherford located?

916 Talon Dr, Suite 102, O Fallon, IL 62269-1848.

What is the taxonomy code for Renee Rutherford?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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