Provider Demographics
NPI:1124859566
Name:RUDAY, SUSAN MICHELLE (MSN, RN)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MICHELLE
Last Name:RUDAY
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DEERFIELD PRESERVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-5966
Mailing Address - Country:US
Mailing Address - Phone:904-829-0814
Mailing Address - Fax:
Practice Address - Street 1:100 DEERFIELD PRESERVE BLVD
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5966
Practice Address - Country:US
Practice Address - Phone:904-829-0814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9618483163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health