Individual
NANNETTE GAY RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1933 WASHINGTON BLVD, BELPRE, OH 45714-2041
(304) 428-3500
(304) 422-7900
Mailing address
418 GRAND PARK DR, SUITE 315, PARKERSBURG, WV 26105-4000
(304) 428-3500
(304) 422-7900
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
NA-05174
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000384706
ANTHEM BLUE CROSS
—
01
—
001714638
MOUNTAIN STATE BLUE CROSS
—
05
—
0066014000
—
WV
01
—
1065483
BRICKSTREET W/C
—
05
—
2141659
—
OH
01
—
9350088
PRIVATE HEALTH CARE SYS.
—
01
—
P00141438
RAILROAD MEDICARE
—
01
—
W46043
THE HEALTH PLAN
—
Enumeration date
06/10/2006
Last updated
05/01/2024
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