Provider Demographics
NPI:1407099518
Name:DUDEK, GINNY OLIVIA (RN)
Entity type:Individual
Prefix:
First Name:GINNY
Middle Name:OLIVIA
Last Name:DUDEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:DITTFIELD
Other - Last Name:DUDEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 LOST LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9570
Mailing Address - Country:US
Mailing Address - Phone:919-544-4187
Mailing Address - Fax:
Practice Address - Street 1:110 RESEARCH PARK IV
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-0191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC66467163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse