Amanda Rudolph, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

27095 Issued in WV

Practice address

5187 US Route 60 Ste 13
Huntington, WV 25705-2076

Phone

(304) 733-5010

NPI assigned

Sep 14, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1306568522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5664 FISHER BOWEN BRANCH RD",
            "city": "WAYNE",
            "state": "WV",
            "postal_code": "255705917",
            "telephone_number": "740-307-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5187 US ROUTE 60 STE 13",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052076",
            "telephone_number": "304-733-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "AMANDA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "27095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Desktop/tablet",
            "affiliation": "N",
            "address_1": "5187 US Route 60 Ste 13",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257052076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tamara Royalty, NP
• Renat Roytenberg, MD,PHD
• Jake Rubenstein, MD
• Nancy Beth Rubio, M.D.
• Stacy Rudd
• Brian Kirk Rudolph, RN
• Carlos Alberto Rueda Rios, M.D
• Lindsey Rae Ruggles, PA-C
• Janis L Rule, ARNP
• Jessica Erin Rulen-Riddle, PA-C

• Licensed Practical Nurse in Huntington, WV
• Providers in Huntington, WV by specialty
• Licensed Practical Nurse in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.