Provider Demographics
NPI:1881833945
Name:RUDAT, ZACHARY AUGUST (CRNP)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:AUGUST
Last Name:RUDAT
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:ZACK
Other - Middle Name:AUGUST
Other - Last Name:RUDAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:383 BAYLES ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-7655
Mailing Address - Country:US
Mailing Address - Phone:251-929-2415
Mailing Address - Fax:
Practice Address - Street 1:750 MORPHY AVE
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-1812
Practice Address - Country:US
Practice Address - Phone:251-929-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-13
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-103761363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily