Basic Information
Provider Information
NPI: 1780292953
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RUTHERFORD
FirstName: KARI
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 ATWELL RD
Address2:  
City: COOPERSTOWN
State: NY
PostalCode: 133261301
CountryCode: US
TelephoneNumber: 6075473480
FaxNumber: 6075476729
Practice Location
Address1: 1 ATWELL RD
Address2:  
City: COOPERSTOWN
State: NY
PostalCode: 133261301
CountryCode: US
TelephoneNumber: 6075473160
FaxNumber: 6075476729
Other Information
ProviderEnumerationDate: 07/14/2020
LastUpdateDate: 09/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
176B00000X703473NYY Other Service ProvidersMidwife 

No ID Information.


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