Individual
MS. AMANDA RUDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LPN
Contact information
Practice address
10 N FULTON AVE, APT. 1L, MOUNT VERNON, NY 10550-1614
(347) 483-1444
Mailing address
10 N FULTON AVE APT 1L, MOUNT VERNON, NY 10550-1611
(914) 979-3407
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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