| NPI | 1235428053 |
|---|---|
| Former Name | KATIE LYNN RUDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F336499) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00947900) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2020-10-14 |