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NPI Code Detail

MEDICARE: JANELLE RUDNICK APRN

MEDICARE: JANELLE RUDNICK APRN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner111945NE
2363LP0808XPsychiatric/Mental Health Nurse Practitioner240046AZ

General Provider Information

NPI Number : 1851766646
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANELLE RUDNICK APRN
Provider Business Mailing Address
First Line : 2400 S AVENUE A
Second Line :
City : YUMA
State : AZ
Zip : 85364-7170
Country : US
Telephone Number : 928-344-2000
Fax Number :
Provider Business Practice Location Address
First Line : 7201 E 31ST PL
Second Line :
City : YUMA
State : AZ
Zip : 85365-8394
Country : US
Telephone Number : 928-336-5660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2015
Last Update Date : 01/14/2025

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