Provider Demographics
NPI:1861043812
Name:DUDEK, MARION HUGHES (RN)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:HUGHES
Last Name:DUDEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 WOODS TRL
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-9542
Mailing Address - Country:US
Mailing Address - Phone:407-321-5527
Mailing Address - Fax:
Practice Address - Street 1:208 WOODS TRL
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-9542
Practice Address - Country:US
Practice Address - Phone:407-321-5527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider