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NPI Code Detail

MEDICARE: ANNETTE JANINE RUDZEWICZ FNP

MEDICARE: ANNETTE JANINE RUDZEWICZ FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner4704126543MI

General Provider Information

NPI Number : 1639193220
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNETTE JANINE RUDZEWICZ FNP
Provider Business Mailing Address
First Line : 14118 PERNELL DR
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48313-5449
Country : US
Telephone Number : 586-247-7211
Fax Number : 612-659-7101
Provider Business Practice Location Address
First Line : 40925 GARFIELD RD
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-2537
Country : US
Telephone Number : 866-389-2727
Fax Number : 612-659-7101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 07/08/2007

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