Individual
MISS DIANNA RUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
804 BELVEDERE ST, CARLISLE, PA 17013-4001
(717) 243-1653
(717) 243-6708
Mailing address
804 BELVEDERE ST, CARLISLE, PA 17013-4001
(717) 243-1653
(717) 243-6708
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA002847L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50047031
CAPITOL BLUE CROSS PROV N
PA
Enumeration date
06/06/2006
Last updated
08/12/2015
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