Most Relevant Information
Provider Data
| NPI Number: | 1003824095 |
| Provider Name: | THERESA E RUDY LPN LICENSED PRACTIC |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/04/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
8837 SCHEELE ROAD
CROSS PLAINS
WI
53528
Practice Location Phone/Fax
| Phone: | 6087981351 |
| Fax: |
Provider Mailing Location
PO BOX 8072
MADISON
WI
537088072
Provider Mailing Phone/Fax
| Phone: | 6084389179 |
| Fax: |