Provider Demographics
NPI:1386456481
Name:RUDISEL, JAYME LEE (FNP)
Entity type:Individual
Prefix:MRS
First Name:JAYME
Middle Name:LEE
Last Name:RUDISEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:HARMONY
Mailing Address - State:IN
Mailing Address - Zip Code:47853-0004
Mailing Address - Country:US
Mailing Address - Phone:812-249-2240
Mailing Address - Fax:
Practice Address - Street 1:803 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834-2437
Practice Address - Country:US
Practice Address - Phone:812-442-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28195013A363LF0000X
IN71016258A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily