Healthcare Provider Details
I. General information
NPI: 1790742534
Provider Name (Legal Business Name): PAULA ISRAEL RHUDE F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/26/2006
Last Update Date: 12/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 P ST
EUREKA CA
95501-0627
US
IV. Provider business mailing address
PO BOX 38
EUREKA CA
95502-0038
US
V. Phone/Fax
- Phone: 707-443-4666
- Fax: 707-445-4499
- Phone: 707-442-2347
- Fax: 707-445-4499
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 167746-1852 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: