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General NPI Number Information
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NPI Number | 1811080062
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Entity Type | Individual
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Provider Name | CHRISTINE NICOLE RUDY RD LDN
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 05/30/2018
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Provider Practice Location Address
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Address Line | 403 WEST RIDGE PIKE
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City | LIMERICK
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State | PA
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Zip | 19468
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Country | US
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Telephone | 610-454-7332
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Fax |
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Provider Business Mailing Address
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Address Line | 20134 VALLEY FORGE CIR
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-1112
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Country | US
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Telephone | 610-454-7332
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | DN003237
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License Number State | PA
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