Provider Demographics
NPI:1760559231
Name:RUDD, VIRGINIA RUTH (RN, ANP, CRNA)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:RUTH
Last Name:RUDD
Suffix:
Gender:F
Credentials:RN, ANP, CRNA
Other - Prefix:
Other - First Name:JENNIE
Other - Middle Name:
Other - Last Name:RUDD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1001 S GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3676
Mailing Address - Country:US
Mailing Address - Phone:717-812-7687
Mailing Address - Fax:
Practice Address - Street 1:7 INDEPENDENCE PT STE 300
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4569
Practice Address - Country:US
Practice Address - Phone:864-522-3700
Practice Address - Fax:864-522-3705
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY418509163W00000X
PARN608166163W00000X, 367500000X
IN28232980A163W00000X
OH433455163W00000X
MO2016039261163W00000X
NE83129163W00000X
KS118952163W00000X
GARN076387163W00000X
NY370027363L00000X
NY302289363LA2200X
NE101378367500000X
FLARNP9444373367500000X
KS557092367500000X
SC27623367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
13793612OtherCAQH