Provider Demographics
NPI:1629883681
Name:MALA, RUDIE ESTHER
Entity type:Individual
Prefix:
First Name:RUDIE
Middle Name:ESTHER
Last Name:MALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 8TH AVE E APT 102
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:ND
Mailing Address - Zip Code:58054-4706
Mailing Address - Country:US
Mailing Address - Phone:202-391-6230
Mailing Address - Fax:
Practice Address - Street 1:207 8TH AVE E APT 102
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:ND
Practice Address - Zip Code:58054-4706
Practice Address - Country:US
Practice Address - Phone:202-391-6230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant