Provider Demographics
NPI:1194064345
Name:RUDISILL, NANCY MARGARET (MS, OTR/L)
Entity type:Individual
Prefix:MISS
First Name:NANCY
Middle Name:MARGARET
Last Name:RUDISILL
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4119 DAVIS PL NW
Mailing Address - Street 2:APT. D301
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-1254
Mailing Address - Country:US
Mailing Address - Phone:703-581-8986
Mailing Address - Fax:
Practice Address - Street 1:201 8TH ST NE
Practice Address - Street 2:SUITE 300
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-6153
Practice Address - Country:US
Practice Address - Phone:202-544-5439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT010000690225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist