SHANE MICHAEL RUDOLPH

PHILADELPHIA, PA
NPI1922696244
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: PA  SP023007)
Enumeration Date2021-01-03
Last Update Date2021-01-03
Business Address
Mr. SHANE MICHAEL RUDOLPH CRNP
10833 KNIGHTS RD
PHILADELPHIA, PA 19154-4207
Phone number: 215-519-7279
Mailing Address
Mr. SHANE MICHAEL RUDOLPH CRNP
10833 KNIGHTS RD
PHILADELPHIA, PA 19154-4207
Phone number: 215-519-7279
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