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General NPI Number Information
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NPI Number | 1346867090
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Entity Type | Individual
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Provider Name | RUDE N HENRY
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Gender | Female
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Dates
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Enumeration Date | 06/29/2020
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Last Update Date | 06/29/2020
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Provider Practice Location Address
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Address Line | 2331 N STATE ROAD 7 STE 206
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-3772
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Country | US
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Telephone | 954-677-0393
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Fax |
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Provider Business Mailing Address
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Address Line | 5713 NW 74TH AVE
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City | TAMARAC
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State | FL
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Zip | 33321-6013
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Country | US
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Telephone | 954-213-2460
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11004115
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License Number State | FL
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