Provider Demographics
NPI:1447615422
Name:RUDASILL, CHRISTA ARVAY
Entity Type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:ARVAY
Last Name:RUDASILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 DUNEDEN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-3117
Mailing Address - Country:US
Mailing Address - Phone:419-966-6452
Mailing Address - Fax:
Practice Address - Street 1:4613 MARBURG AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-5005
Practice Address - Country:US
Practice Address - Phone:513-782-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021541363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily