| NPI | 1770093155 |
|---|---|
| Former Name | SHANNON MARIE RUDESHEIM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 22686) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 22686) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 22686) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 22686) | |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2022-03-25 |