Provider Demographics
NPI:1811109986
Name:RUDOLPH, ANDREA CHRISTINE (RN, MSN, ACNP)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:CHRISTINE
Last Name:RUDOLPH
Suffix:
Gender:F
Credentials:RN, MSN, ACNP
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Mailing Address - Street 1:11663 GORHAM AVE
Mailing Address - Street 2:APT. #8
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-4749
Mailing Address - Country:US
Mailing Address - Phone:310-207-6989
Mailing Address - Fax:310-882-7005
Practice Address - Street 1:100 UCLA MEDICAL PLZ
Practice Address - Street 2:SUITE 760
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-264-7246
Practice Address - Fax:310-882-7005
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA13834363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care