Basic Information
Provider Information
NPI: 1366196776
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ORTEGA-RUTHERFORD
FirstName: BARBARA
MiddleName: MARGARITA
NamePrefix:  
NameSuffix:  
Credential: BSN, RN, CNOR, RNFA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10582 E RALPH ALVAREZ PL
Address2:  
City: TUCSON
State: AZ
PostalCode: 857475885
CountryCode: US
TelephoneNumber: 5204442753
FaxNumber:  
Practice Location
Address1: 10582 E RALPH ALVAREZ PL
Address2:  
City: TUCSON
State: AZ
PostalCode: 857475885
CountryCode: US
TelephoneNumber: 5204442753
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/05/2022
LastUpdateDate: 02/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/05/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WR0006XRN071905AZY Nursing Service ProvidersRegistered NurseRegistered Nurse First Assistant

No ID Information.


Home