Provider Demographics
NPI:1386154573
Name:RUDY, FAITH ELIZABETH
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:ELIZABETH
Last Name:RUDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17240 TWINOAKS PL
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:VA
Mailing Address - Zip Code:20158-3160
Mailing Address - Country:US
Mailing Address - Phone:540-454-1299
Mailing Address - Fax:
Practice Address - Street 1:17240 TWINOAKS PL
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:VA
Practice Address - Zip Code:20158-3160
Practice Address - Country:US
Practice Address - Phone:540-454-1299
Practice Address - Fax:540-454-1299
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program