Provider Demographics
NPI:1275652851
Name:RUDIN, MARGARET M (APRN)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:M
Last Name:RUDIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 AVON MEADOW LN # 203
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3753
Mailing Address - Country:US
Mailing Address - Phone:860-920-9720
Mailing Address - Fax:
Practice Address - Street 1:40 AVON MEADOW LN # 203
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3753
Practice Address - Country:US
Practice Address - Phone:860-920-9720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003612363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
7272OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER