Individual
CAROLINE RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
9055 SPRINGBROOK DR NW, COON RAPIDS, MN 55433-5841
(763) 780-9155
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(122) 629-0006
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2021084101
MN
Other
Enumeration date
11/04/2021
Last updated
05/18/2022
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