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General NPI Number Information
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NPI Number | 1669258802
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Entity Type | Individual
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Provider Name | TAYLOR RENEE RUTHERFORD CRNP, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 1120 PIKE ST
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City | HUNTINGDON
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State | PA
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Zip | 16652-1117
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Country | US
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Telephone | 814-643-6520
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Fax |
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Provider Business Mailing Address
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Address Line | 215 1ST AVE
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City | ALTOONA
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State | PA
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Zip | 16602-3910
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Country | US
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Telephone | 814-932-0244
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP028101
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License Number State | PA
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