Rutherford, Susan Owen

Rutherford, Susan Owen is an individual health care provider with primary practice located at 3333 Evergreen Dr Ne , Grand Rapids MI 49525-9493. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Rutherford, Susan Owen can be contacted via phone (616) 364-4200.

Contact Information

Primary practice address
3333 Evergreen Dr Ne Grand Rapids MI 49525-9493
Phone: (616) 364-4200
Fax: (616) 364-7347
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4704207135 Michigan

Profile Details

NPI number 1598728636
LBN Legal business name Rutherford, Susan Owen
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Jul 3rd, 2014 - about 10 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 1598728636 NPPES
Michigan MEDICAID 104349131
Michigan Other 430D110990
Michigan Other CE1952
Michigan Other 0875931
Michigan Other 430044534
Michigan Other SR207135

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