Provider Demographics
NPI:1194287391
Name:RUTHERFORD, LUANA LOUISE (PMHNP)
Entity type:Individual
Prefix:
First Name:LUANA
Middle Name:LOUISE
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7661 N BELLWETHER DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-8617
Mailing Address - Country:US
Mailing Address - Phone:520-334-0941
Mailing Address - Fax:
Practice Address - Street 1:41705 N CLUB POINTE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086-1961
Practice Address - Country:US
Practice Address - Phone:520-334-0041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ224024363LP0808X
COC-APN.0002125-C-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health