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NPI Code Detail

MEDICARE: KATHERINE RUDENICK

MEDICARE: KATHERINE RUDENICK
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
1225100000XPhysical Therapist12811MN

General Provider Information

NPI Number : 1730807843
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE RUDENICK
Provider Business Mailing Address
First Line : 3835 SUPREME CT NW STE 2
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-4485
Country : US
Telephone Number : 218-444-8280
Fax Number :
Provider Business Practice Location Address
First Line : 3835 SUPREME CT NW STE 2
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-4485
Country : US
Telephone Number : 218-441-5232
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2022
Last Update Date : 12/30/2025

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Directions to “ KATHERINE RUDENICK ” Practice Location

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