Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 353798 | OH |
NPI | 1013302793 |
---|---|
Provider Name | Allison Rudy |
First Address | Fort Mitchell, KY 41017-2959 |
Second Address | Cincinnati, OH 45229-3014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2015 |
Last Update Date | 14/08/2015 |