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Individual
JAMIE RUDICEL
Active
Individual
JAMIE RUDICEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28165041A
IN
363L00000X
Nurse Practitioner
Primary
71003706A
IN
363LA2200X
Adult Health Nurse Practitioner
041502665
IL
363LA2200X
Adult Health Nurse Practitioner
209022605
IL
363LA2200X
Adult Health Nurse Practitioner
71003706A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000731151
ANTHEM PROVIDER NUMBER
IN
05
—
201034850
—
IN
Enumeration date
06/09/2011
Last updated
01/14/2026
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