Individual
LISA DAWN RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2937 ALASKAN AVE, BILLINGS, MT 59101-6851
(406) 256-7126
Mailing address
2937 ALASKAN AVE, BILLINGS, MT 59101-6851
(406) 256-7126
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
32041
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32041
MONTANA BOARD OF NURSING
MT
Enumeration date
06/28/2010
Last updated
06/28/2010
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