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General NPI Number Information
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NPI Number | 1932598927
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Entity Type | Individual
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Provider Name | SEANA RUTHERFORD NP-C
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Gender | Female
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Dates
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Enumeration Date | 01/14/2015
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 7575 NORTHCLIFF AVE STE 103
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City | BROOKLYN
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State | OH
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Zip | 44144-3267
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Country | US
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Telephone | 216-331-6750
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Fax |
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Provider Business Mailing Address
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Address Line | 1803 GROVEWOOD AVE
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City | PARMA
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State | OH
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Zip | 44134-2027
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 367604
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | COA.17707-NP
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License Number State | OH
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