Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | UP001534J | PA |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | UP005607D | PA |
NPI | 1013275734 |
---|---|
Provider Name | Ms. Marion E. Rudek |
First Address | Pittsburgh, PA 15226-2111 |
Second Address | Pittsburgh, PA 15217-1350 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2012 |
Last Update Date | 01/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S61765 | (02) | DE |