Provider Demographics
NPI:1386893295
Name:RUDY, SUSAN FAITH (MSN, FNP-BC, CORLN)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:FAITH
Last Name:RUDY
Suffix:
Gender:F
Credentials:MSN, FNP-BC, CORLN
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Mailing Address - Street 1:10 CENTER DRIVE
Mailing Address - Street 2:BUILDING 10 ROOM 5C409
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892
Mailing Address - Country:US
Mailing Address - Phone:301-496-4887
Mailing Address - Fax:301-451-5404
Practice Address - Street 1:10 CENTER DRIVE
Practice Address - Street 2:BUILDING 10 ROOM 5C409
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892
Practice Address - Country:US
Practice Address - Phone:301-496-4887
Practice Address - Fax:301-451-5404
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDNP084977363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR084977OtherMARYLAND BOARD OF NURSING
MDN36082OtherSTATE OF MD DEPT OF HEALTH AND MENTAL HYGIENE, DIVISION OF DRUG CONTROL
MDN36082OtherSTATE OF MD DEPT OF HEALTH AND MENTAL HYGIENE, DIVISION OF DRUG CONTROL