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Individual
MS. AMANDA RUDOLPH
Active
Individual
MS. AMANDA RUDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LPN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
746171
NY
164W00000X
Licensed Practical Nurse
316023
NY
251J00000X
Nursing Care Agency
316023
NY
Other
Enumeration date
10/22/2013
Last updated
06/15/2019
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