Provider Demographics
NPI:1376579615
Name:RUDD ARIETA, MARGARET P (APRN, PPNP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:P
Last Name:RUDD ARIETA
Suffix:
Gender:F
Credentials:APRN, PPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 OTIS ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-2054
Mailing Address - Country:US
Mailing Address - Phone:508-572-9939
Mailing Address - Fax:
Practice Address - Street 1:120 OTIS ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-2054
Practice Address - Country:US
Practice Address - Phone:508-572-9939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA169769163WH0200X, 163WP0200X
MA164764208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP9835OtherBLUE CROSS BLUE SHIELD