Marie Rose Fudge

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

216 Dalton Street
PO Box 90
Haines, AK 99827

Phone

(907) 766-6389

NPI assigned

Jul 15, 2025

Last updated

Jul 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1255223285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 446",
            "city": "HAINES",
            "state": "AK",
            "postal_code": "998270446",
            "telephone_number": "269-419-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 DALTON STREET",
            "address_2": "PO BOX 90",
            "city": "HAINES",
            "state": "AK",
            "postal_code": "99827",
            "telephone_number": "907-766-6389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUDGE",
        "first_name": "MARIE",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard Feldman, MD
• Katherine Fossman, RDN, LD
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• Monique Octavia Frith
• Krystal R Gauley, LMT
• Claire Giordano
• Madeline Kathleen Haff, OT
• Haines Assisted Living, Inc.
• Haines Borough (Haines Volunteer Fire Department)

• Case Manager/Care Coordinator in Haines, AK
• Providers in Haines, AK by specialty
• Case Manager/Care Coordinator in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.