Individual
DIANNE M RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
124 E BANDERA RD # 102, BOERNE, TX 78006-2849
(830) 816-2312
(830) 816-2349
Mailing address
124 E BANDERA RD # 102, BOERNE, TX 78006-2849
(830) 816-2312
(830) 816-2349
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
561280
TX
363L00000X
Nurse Practitioner
561280
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
AP113442
TX
Other
Enumeration date
06/02/2006
Last updated
04/15/2025
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