Provider Demographics
NPI:1528401528
Name:RUNDLE, ANNE (MS RN)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:RUNDLE
Suffix:
Gender:F
Credentials:MS RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 W MAIN ST
Mailing Address - Street 2:#9
Mailing Address - City:MERRIMAC
Mailing Address - State:MA
Mailing Address - Zip Code:01860-1940
Mailing Address - Country:US
Mailing Address - Phone:978-620-1770
Mailing Address - Fax:
Practice Address - Street 1:12 METHUEN ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1700
Practice Address - Country:US
Practice Address - Phone:978-620-1770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216702163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse