AMANDA B RUDOLPH (NPI# 1043452972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043452972 |
| Entity Type | Individual |
| Full Name | AMANDA B RUDOLPH |
| Credential | CPNP |
| Practice Address |
1011 W Grove St Ste 120 Kaufman TX 75142-1883 |
| Mailing Address |
4901 Veterans Memorial Blvd Metairie LA 70006-5210 |
| Practice Telephone | 9729321319 |
| Practice Fax Number | 9729321396 |
| Mailing Telephone | 5048871133 |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2014-04-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | AP05388 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
162093 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1552992 | 05 | |
| MS | 09079528 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114558459 | Amanda Rudolph | Behavior Technician | 2121 41st Ave, Capitola, CA 95010-2056 | 2020-01-27 |
| 1306274725 | Amanda Rudolph | Registered Nurse | 10 N Fulton Ave, Apt. 1l, Mount Vernon, NY 10550-1614 | 2013-10-22 |
| Street Address |
1011 W GROVE ST STE 120 |
| City | KAUFMAN |
| State | TX |
| Zip Code | 75142-1883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467074302 | Brad James Gautney | Registered Nurse | 1011 W Grove St Ste 120, Kaufman, TX 75142-1883 | 2020-05-14 |
| 1720632961 | Jessica Mason | Nurse Practitioner | 1011 W Grove St Ste 120, Kaufman, TX 75142-1883 | 2019-07-25 |
| 1083144752 | Melissa Martin | Registered Nurse | 1011 W Grove St Ste 120, Kaufman, TX 75142-1883 | 2017-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301996 | Interventional Partners LLC | Podiatrist | 874 W. Highway 243, Ste. 110, Kaufman, TX 75142 | 2019-11-20 |
| 1447731369 | Misty Dawn Wainright | Occupational Therapy Assistant | 1803 Tx 243, Kaufman, TX 75142 | 2018-08-28 |
| 1003286907 | Heather Marie Jones | Occupational Therapy Assistant | 2700 Commerce Way Suite 100, Suite 100, Kaufman, TX 75142 | 2015-10-05 |
| 1598140519 | Gruenepointe 1 Kaufman, LLC | Skilled Nursing Facility | 1803 Hwy. 243 Est, Kaufman, TX 75142 | 2015-07-21 |
| 1235526583 | Texas Dentistry | Dentist | 100 East Kings Fort Parkway, Ste# 100, Kaufman, TX 75142 | 2015-04-23 |
| 1407189517 | Window To The Body | Dentist | 850 W Hwy 243, Kaufman, TX 75142 | 2009-09-09 |
| 1851527667 | Ashley Stewart | Speech-Language Pathologist | 1701 South Washignton Suite C, Kaufman, TX 75142 | 2009-06-08 |
| 1881862779 | Nancy Carol Cook | Obstetrics & Gynecology | 874 Hwy 243 W, Suite 115 Dr Angelina Rivero, Kaufman, TX 75142 | 2008-02-14 |
| 1346448263 | Mcmahon's Foundation Christian Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4883 County Road 4101, Kaufman, TX 75142 | 2007-07-03 |
| 1427112218 | Misty M Fairchild | Occupational Therapist | 2700 Commerce Way Ste 100, Kaufman, TX 75142 | 2006-12-19 |
| Find all providers in zip 75142 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821480179 | Whitney Fuller Grundy | Nurse Practitioner | 1011 W Grove St, Kaufman, TX 75142-1882 | 2015-02-24 |
| 1952563876 | Joan S Costello | Nurse Practitioner | 1011 W Grove St, Kaufman, TX 75142 | 2008-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629308 | Megan Marie Burson | Nurse Practitioner | 9002 Culebra Rd Unit 100, San Antonio, TX 78251-2873 | 2020-11-04 |
| 1275134355 | Trevor Hill | Nurse Practitioner | 19708 Northwest Fwy Ste 500, Jersey Village, TX 77065-5626 | 2020-11-04 |
| 1346849817 | Abbie Leigh Collins | Nurse Practitioner | 4499 Medical Dr Ste 289, San Antonio, TX 78229-3712 | 2020-10-25 |
| 1770182636 | Jenna Donlon | Nurse Practitioner | 3201 Western Center Blvd Ste 125, Fort Worth, TX 76137-7135 | 2020-10-21 |
| 1356949697 | Elizabeth Danielle Harrington | Nurse Practitioner | 213 Woodbine Dr, Burleson, TX 76028-6175 | 2020-10-09 |
| 1780291229 | Alexandra Messer | Nurse Practitioner | 6435 S Farm To Market, #201, Heath, TX 75032 | 2020-09-29 |
| 1679189567 | Jessica Dawn Crow | Nurse Practitioner | 801 Nuthatch Ct, Northlake, TX 76226-2863 | 2020-09-16 |
| 1457965436 | Jeanan Alameddine | Nurse Practitioner | 823 Catalpa Pl, Missouri City, TX 77459-5709 | 2020-09-07 |
| 1073127080 | Thelma Ivy Reyesmcchesney | Nurse Practitioner | 163 Village East Dr, Los Fresnos, TX 78566-3104 | 2020-09-07 |
| 1760095251 | Chelsey Jensen Bailey | Nurse Practitioner | 433 Sagebrush Dr, Aledo, TX 76008-1340 | 2020-08-25 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on AMANDA B RUDOLPH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.