Rutherford, Jonathan Howell

Rutherford, Jonathan Howell is an sole proprietor health care provider with primary practice located at 155 Calle Portal Ste 300 , Sierra Vista AZ 85635-2900. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Rutherford, Jonathan Howell can be contacted via phone (520) 459-3011.

Contact Information

Primary practice address
155 Calle Portal Ste 300 Sierra Vista AZ 85635-2900
Phone: (520) 459-3011
Fax: (520) 364-4261
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 260129 Arizona

Profile Details

NPI number 1154091932
LBN Legal business name Rutherford, Jonathan Howell
Credentials PMHNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 14th, 2021
Last updated Feb 10th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154091932 NPPES
Arizona MEDICAID 106788

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