PAMELA ANNA RUDNICKI (NPI# 1215386677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215386677 |
| Entity Type | Individual |
| Full Name | PAMELA ANNA RUDNICKI |
| Credential | MD |
| Practice Address |
301 Fisher St Rm 5a127 Keesler Afb MS 39534-2508 |
| Practice Telephone | 2283765571 |
| Practice Fax Number | 2283760083 |
| Mailing Telephone | 2283765571 |
| Mailing Fax Number | 2283760083 |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2016-06-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | Other Service Providers |
| Street Address |
301 FISHER ST RM 5A127 |
| City | KEESLER AFB |
| State | MS |
| Zip Code | 39534-2508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215929039 | Roger E Pradelli | Dentist | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2005-08-17 |
| 1508427394 | Anthony Wayne Reddin Jr. | Nurse Anesthetist, Certified Registered | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2019-06-24 |
| 1215496575 | Benjamin Douglas | Physician Assistant | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2019-03-17 |
| 1801381736 | Francis Essien | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2018-06-23 |
| 1932697893 | Eric James Rigg | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2018-04-26 |
| 1912401084 | Shannon Reed | Advanced Practice Midwife | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2018-03-22 |
| 1568972586 | Nicholas P Robertson | Registered Nurse | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2017-10-04 |
| 1578093126 | Jaclyn Kaye Stacy | Internal Medicine | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2017-06-15 |
| 1700315686 | Joseph Cook | Internal Medicine | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2017-06-05 |
| 1861926461 | Benjamin Robert Prince | Family Medicine | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2017-04-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316568918 | Hanna Chang | Student in an Organized Health Care Education/Training Program | 81 Msgs/gme (keesler Afb), 301 Fisher St, Rm 5a127, Biloxi, MS 39534 | 2020-05-05 |
| 1720617079 | Briana Polk | Student in an Organized Health Care Education/Training Program | Keesler Air Force Base, 301 Fisher Street, Biloxi, MS 39534 | 2020-04-07 |
| 1437718756 | Marquise Westbrook | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Rm 1g123, Keesler Afb, MS 39534 | 2019-06-11 |
| 1124682729 | Joseph Paul Cervone | Student in an Organized Health Care Education/Training Program | 81 Mdss/gme 301 Fisher St, Rm 1g123, Keesler Afb, MS 39534 | 2019-04-29 |
| 1083120851 | Kaitlin May Gruenberg | Student in an Organized Health Care Education/Training Program | 81 Msgs/gme, 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2017-12-15 |
| 1760912513 | Michael Zipper | Military Health Care Provider | 301 Fisher St, Rm 5a127, 81msgs/sgcq, Keesler Afb, MS 39534 | 2017-06-14 |
| 1184073181 | 81msgs/sgcq | General Acute Care Hospital | 81msgs/sgcq, 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2016-06-09 |
| 1174972772 | Usaf 81st Medical Group | Military Hospital | 81msgs/sgcq 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2016-06-06 |
| 1548644677 | Jim Li | Dentist | 81st Medical Group, Keesler Afb, Apo, AA 39534 | 2015-07-18 |
| 1245610872 | Zachary Austin Masters | Surgery | 301 Fisher Street, Rm 5a127, Keesler Air Force Base, MS 39534 | 2015-06-09 |
| Find all providers in zip 39534 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558853689 | John Levasseur | Military Health Care Provider | 301 Fisher St Rm 1g123, Keesler Afb, MS 39534-2508 | 2018-06-05 |
| 1760912513 | Michael Zipper | Military Health Care Provider | 301 Fisher St, Rm 5a127, 81msgs/sgcq, Keesler Afb, MS 39534 | 2017-06-14 |
| 1780113670 | Jaime Patricia Umberger | Military Health Care Provider | 301 Fisher St Rm 5a127, Keesler Afb, MS 39534-2508 | 2017-06-05 |
| 1730538067 | Elizabeth Brooke Honeycutt | Military Health Care Provider | 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534-2508 | 2016-06-07 |
| 1932558392 | Evan Dannhardt | Military Health Care Provider | 301 Fisher St Rm 5a127, Keesler Afb, MS 39534-2508 | 2016-06-07 |
| 1902826662 | Brian Anthony Katen | Military Health Care Provider | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396250031 | Lilly Pad Home Health, LLC | Military Health Care Provider | 1507 Hardy St Ste 201, Hattiesburg, MS 39401-4978 | 2017-12-04 |
| 1881945566 | Robert Ray Ellis | Military Health Care Provider | 10194 Cottage Ct, Diberville, MS 39540-4744 | 2012-09-21 |
| 1457566374 | James Wesley Clements | Military Health Care Provider | 664 S State St, Jackson, MS 39201-5611 | 2007-05-14 |
| 1215049283 | Angela Victoria Thrahser | Military Health Care Provider | 111 G St, Arnold Annex, Bldg 5901, Biloxi, MS 39534-2410 | 2006-08-31 |
| 1861453870 | Daniel Bruce Smith | Military Health Care Provider | 22224 Lorene Road, Gulfport, MS 39503 | 2006-03-29 |
| 1093349094 | Victor Dang Hoang | Military Health Care Provider | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-02-27 |
| 1700438710 | Jacob Travis Burlew | Military Health Care Provider | 500 Fisher St, Biloxi, MS 39534-2502 | 2019-07-10 |
| 1568936532 | James Barbosa | Military Health Care Provider | 301 Fisher St, Biloxi, MS 39534-2508 | 2019-01-14 |
| 1811482730 | Gregory Buford Jr. | Military Health Care Provider | 301 Fisher St, Biloxi, MS 39534-2508 | 2018-06-22 |
| 1992225262 | Bradly S. Brown | Military Health Care Provider | 500 Fisher St, Biloxi, MS 39534-2502 | 2017-06-27 |
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| City | KEESLER AFB |
| Zip Code | 39534 |
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| 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.