MS. KIM LOUISE FUDGE (NPI# 1770732349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770732349 |
| Entity Type | Individual |
| Full Name | MS. KIM LOUISE FUDGE |
| Credential | PA-C |
| Practice Address |
Erie Ave At Front St St Christopher's Hospital for Children Philadelphia PA 19134 |
| Mailing Address |
Erie Ave At Front St St Christophers Hospital for Children Philadelphia PA 19027-1095 |
| Practice Telephone | 2154278190 |
| Practice Fax Number | 2154274638 |
| Mailing Telephone | 2154278190 |
| Mailing Fax Number | 2154274638 |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2008-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | MA-002885-L | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
ERIE AVE AT FRONT ST ST CHRISTOPHER'S HOSPITAL FOR CHILDREN |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457349359 | Iraj Rezvani | Pediatrics | Erie Ave At Front St, Scpa Endocrinology, Philadelphia, PA 19134-1095 | 2005-10-13 |
| 1649438045 | Leah Scherzer | Pediatrics | Erie Ave At Front St, Philadelphia, PA 19134 | 2008-06-02 |
| 1093935298 | Laura W Forrest | Nurse Practitioner | Erie Ave At Front St, Nelson Pavilion Ste 2045, - Scpa Gastroenterology, Philadelphia, PA 19134 | 2007-04-27 |
| 1205969607 | Sandi Mae Vivienne See Tai | Pediatrics | Erie Ave At Front St, Philadelphia, PA 19134 | 2007-03-14 |
| 1235211046 | Apple Drugs Inc | Pharmacy | Erie Ave At Front St, Philadelphia, PA 19134 | 2006-10-20 |
| 1831203421 | Ignacio Valencia | Psychiatry & Neurology | Erie Ave At Front St, Scpa Neurology, Philadelphia, PA 19134 | 2006-08-19 |
| 1164466892 | Cesar Igor Mesia | Pediatrics | Erie Ave At Front St, Philadelphia, PA 19134 | 2006-06-15 |
| 1023051182 | Michael Louis Szatkowski | Pediatrics | Erie Ave At Front St, Philadelphia, PA 19134-1095 | 2006-06-14 |
| 1003853698 | Rajeev Prasad | Surgery | Erie Ave At Front St, Scpa General Surgery, Philadelphia, PA 19134 | 2006-06-01 |
| 1952358608 | Marta Rozans | Pediatrics | Erie Ave At Front St, Philadelphia, PA 19134 | 2006-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871137208 | My Philadelphia Pharmacy Inc | Pharmacy | 2901 E Thompson St, Front Store, Philadelphia, PA 19134 | 2019-10-29 |
| 1588125793 | Bret Johnson | Student in an Organized Health Care Education/Training Program | Pediatric Residency Program, 160 East Erie Ave, Philadelphia, PA 19134 | 2019-03-29 |
| 1053881672 | Ana Y Almanzar | Psychologist | 3513 North Water Street, Philadelphia, PA 19134 | 2018-11-27 |
| 1861974206 | Stephanie C Curtis | Registered Nurse | St. Christopher's Hospital for Children 160 E Erie Ave, Philadelphia, PA 19134 | 2018-09-01 |
| 1700371978 | Kristi Ford | Nurse Practitioner | 160 E Erie Ave # 21542, Philadelphia, PA 19134 | 2018-06-28 |
| 1700370178 | Natalie Martinez | Case Manager/Care Coordinator | 3528 I St Ste 1, Philadelphia, PA 19134 | 2018-06-19 |
| 1205352309 | Personal Injury Clinic PC | Chiropractor | 2301 E Allegheny Ave Ste 305a, Philadelphia, PA 19134 | 2017-08-21 |
| 1306376280 | Port Richmond Counseling Practices | Clinic/Center | 3110 Aramingo Ave, Suite 1, Philadelphia, PA 19134 | 2017-06-14 |
| 1760864441 | Jason Roy Toews | Pediatrics | 160 East Eire Ave, St. Christopher's Hospital for Children, Philadelphia, PA 19134 | 2015-06-18 |
| 1376933291 | David Tanney Yusavitz | Nurse Practitioner | 160 E Erie Ave Ste 2015, Philadelphia, PA 19134 | 2015-01-30 |
| Find all providers in zip 19134 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283986 | Margaret Ann Malloy | Physician Assistant | 3223 N Broad St Fl 1, Philadelphia, PA 19140-5007 | 2020-10-20 |
| 1174122493 | Juliana Debnam | Physician Assistant | 235 S 15th St Apt 904, Philadelphia, PA 19102-5031 | 2020-10-19 |
| 1457950867 | Kyllington Spotts | Physician Assistant | 1151 N 3rd St Unit 301, Philadelphia, PA 19123-1578 | 2020-10-19 |
| 1598375925 | Meredith Jeanne Behr | Physician Assistant | 5401 N Broad St, Philadelphia, PA 19141 | 2020-07-31 |
| 1457977944 | Jiyean Yoo | Physician Assistant | 2929 Walnut St Apt 4424, Philadelphia, PA 19104-5096 | 2020-06-19 |
| 1356987747 | Jennifer Rose Cueni | Physician Assistant | 2120 Brandywine St, Philadelphia, PA 19130-3107 | 2019-11-21 |
| 1730740408 | Olivia Anne Leventry | Physician Assistant | 109 Fairmount Ave, Philadelphia, PA 19123-3004 | 2019-06-24 |
| 1588136055 | Jefferson University Physcians | Physician Assistant | 1020 Sansom St Fl 10, Philadelphia, PA 19107-5002 | 2018-12-21 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922589365 | Rachel Diane Simonsen | Physician Assistant | 1741 Frankford Ave Ste 100a, Philadelphia, PA 19125-2445 | 2018-08-23 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19134 |
Please comment or provide details below to improve the information on MS. KIM LOUISE FUDGE.
| 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.