ABBY ROSE RUDOLPH


Address: 1057 N Garland Ave, Fayetteville, AR 72701-1722
Phone: 4799665088

ABBY ROSE RUDOLPH (NPI# 1235581802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235581802
Entity Type Individual
Full Name ABBY ROSE RUDOLPH
Credential APRN
Practice Address 1057 N Garland Ave
Fayetteville
AR 72701-1722
Practice Telephone 4799665088
Mailing Telephone 4799665088
Enumeration Date 2016-07-07
Last Update Date 2016-07-07
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
A004804 AR Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1057 N GARLAND AVE
City FAYETTEVILLE
State AR
Zip Code 72701-1722

Providers in the same location

NPI Name Taxonomy Address Enumeration
1255688099 Karas Walk-in Clinic Family Medicine 1057 N Garland Ave, Fayetteville, AR 72701-1722 2012-08-10
1164804209 Mindy Kazery Nurse Practitioner 1057 N Garland Ave, Fayetteville, AR 72701-1722 2015-06-25

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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Competitor

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City FAYETTEVILLE
Zip Code 72701

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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