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Individual

MRS. MARY JANE RUDOWSKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
24755 CHAGRIN BLVD, 345, BEACHWOOD, OH 44122-5682
(216) 464-0778
(216) 765-1461
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN166982
OH
363L00000X
Nurse Practitioner
Primary
COA1145NP
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3085012
OH
Enumeration date
02/23/2010
Last updated
07/05/2011
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