Provider Demographics
NPI:1811938624
Name:RUDNER, NANCY (DRPH, NP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:RUDNER
Suffix:
Gender:F
Credentials:DRPH, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 QUEENS MIRROR CIR
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-4404
Mailing Address - Country:US
Mailing Address - Phone:407-350-9896
Mailing Address - Fax:
Practice Address - Street 1:558 QUEENS MIRROR CIR
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-4404
Practice Address - Country:US
Practice Address - Phone:407-350-9896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1887282363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily