Most Relevant Information
Provider Data
| NPI Number: | 1003540204 |
| Provider Name: | HANNAH RAE RUDOLPH |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 10004442A |
Most Important Dates
| Enumeration Date: | 07/13/2022 |
| Last Updated: | 08/06/2024 |
Provider Practice Location
2800 S STATE ROAD 135 STE 250
GREENWOOD
IN
461436223
Practice Location Phone/Fax
| Phone: | 3173001788 |
| Fax: | 3177438103 |
Provider Mailing Location
111 NEW HAMPSHIRE AVE STE 2
PORTSMOUTH
NH
038012864
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |