Provider Demographics
NPI:1669219093
Name:RUDMANN, JAUNITA KAE (MA, PT)
Entity type:Individual
Prefix:
First Name:JAUNITA
Middle Name:KAE
Last Name:RUDMANN
Suffix:
Gender:F
Credentials:MA, PT
Other - Prefix:
Other - First Name:JAUNITA
Other - Middle Name:KAE
Other - Last Name:LOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, PT
Mailing Address - Street 1:205 JADE DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-4026
Mailing Address - Country:US
Mailing Address - Phone:304-216-5887
Mailing Address - Fax:
Practice Address - Street 1:205 JADE DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-4026
Practice Address - Country:US
Practice Address - Phone:304-216-5887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV000872225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist