MRS. KELLY MARIE RUDROFF (NPI# 1609216159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609216159 |
| Entity Type | Individual |
| Full Name | MRS. KELLY MARIE RUDROFF |
| Credential | RN, MSN |
| Practice Address |
915 N Grand Blvd Saint Louis MO 63106 |
| Mailing Address |
2909 Shenandoah Ave Saint Louis MO 63104-1739 |
| Practice Telephone | 3146524100 |
| Mailing Telephone | 3145837698 |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2018-04-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 900243 | MS | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2016042952 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | UNSURE OF ISSUER | 1609216159 | 01 |
| Street Address |
915 N GRAND BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033115480 | Jamie Lynn Swanson | Physician Assistant | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2005-06-21 |
| 1821602756 | Courtney Kay Duberry | Optometrist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-09-08 |
| 1043820053 | Kathryn Marie Storm | Pharmacist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-08-04 |
| 1326657230 | Rebecca Oluwafunmito Babalola | Pharmacist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-07-27 |
| 1639787328 | Justin Clarke Liedke | Pharmacist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-07-19 |
| 1639796899 | Taylor Anderson | Nurse Practitioner | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-07-02 |
| 1427675800 | Lauren Elizabeth Smith | Nurse Practitioner | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-07-01 |
| 1427675925 | Christa Marie Stoutenborough | Nurse Practitioner | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-06-30 |
| 1992322739 | Alexia Lambos Georges | Perfusionist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-06-27 |
| 1912522210 | Meaghan Elizabeth Lecture | Nurse Practitioner | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770027997 | Superior Manor of Downtown LLC | Assisted Living Facility | 1501 Clinton St., St Louis, MO 63106 | 2016-12-07 |
| 1811361454 | James Preston Jr. | Pharmacist | 915 N. Grand Vlvd, Pharmacy Dept., John Cochran Va Medical Center, Saint Louis, MO 63106 | 2015-11-19 |
| 1245656354 | Julie Marie Albsmeyer | Physician Assistant | 915 North Grand 111-jc-gi, John Cochran Va Hospital, St. Louis, MO 63106 | 2014-03-13 |
| 1932523230 | Cathy Yeung | Registered Nurse | 715 N Grand Blvd., St Louis, MO 63106 | 2014-02-07 |
| 1902149388 | Amanda Foley | Doula | 4056 Humphrey Street, Saint Louis, MO 63106 | 2013-04-03 |
| 1942569876 | Cornelia Charles | Internal Medicine | 915 Norh Grand Blvd, Saint Louis, MO 63106 | 2012-05-12 |
| 1124334396 | Kasandra Ann Tinajero | Registered Nurse | 915 N. Grand Blvd., St. Louis, MO 63106 | 2010-08-26 |
| 1366673931 | Cassandra Vernetta Talbert | Social Worker | 915 N. Grand., 122/jc Social Work Dept. V.a. Medical Center, St. Louis, MO 63106 | 2009-07-30 |
| 1497910707 | Robert Louis Tillman | Pharmacy Technician | 915 N Grand Ave, St. Louis, MO 63106 | 2008-07-25 |
| 1861676686 | Bradley Dean Overmeyer | Social Worker | 915 N Grand Blvd., Social Work Service, St. Louis, MO 63106 | 2007-12-28 |
| Find all providers in zip 63106 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720816 | Blake Christian Cory | Nurse Practitioner | 615 S Ballas Rd # 2015, Saint Louis, MO 63122-5314 | 2020-11-08 |
| 1265032346 | Sara Lynn Gillespie | Nurse Practitioner | 2424 S 9th St Apt 215, Saint Louis, MO 63104-4717 | 2020-10-28 |
| 1174123509 | Megan Ashley Wagner | Nurse Practitioner | 10012 Kennerly Rd Ste 406, Saint Louis, MO 63128-2197 | 2020-10-26 |
| 1467059972 | Anissa Rasul | Nurse Practitioner | 10631 Thayer Dr, Saint Louis, MO 63123-6018 | 2020-10-07 |
| 1124635388 | Brittney Sherrell Burks | Nurse Practitioner | 10314 Briar Hollow Dr Apt 7, Saint Louis, MO 63146-5777 | 2020-09-30 |
| 1629684865 | Nicole Burdge | Nurse Practitioner | 9230 Laurel Hill Dr, Saint Louis, MO 63126-2820 | 2020-09-22 |
| 1932724614 | Oluwatoyin Olufunke Adegboyega | Nurse Practitioner | 3318 Saint Vincent Ave, Saint Louis, MO 63104-1338 | 2020-06-09 |
| 1497376487 | Jessica A Spring | Nurse Practitioner | 6023 Lansdowne Ave, Saint Louis, MO 63109-2243 | 2020-04-30 |
| 1932728466 | Lucy Wachuka Kamau | Nurse Practitioner | 4412 Clarence Ave, Saint Louis, MO 63115-3108 | 2020-04-14 |
| 1275169567 | Lindsay Jones | Nurse Practitioner | 1115 Olivette Executive Pkwy Ste 100, Saint Louis, MO 63132-3265 | 2020-03-18 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63106 |
Please comment or provide details below to improve the information on MRS. KELLY MARIE RUDROFF.
| 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.