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Mr. Glen Steven Rudolph I, LPN
Licensed Practical Nurse in Plattsburgh, New York
NPI 1386819571

Glen Steven Rudolph I is a Licensed Practical Nurse based in Plattsburgh, NY. Glen Steven Rudolph I practices in Plattsburgh, NY and has the professional credentials of LPN. The NPI Number for Glen Steven Rudolph I is 1386819571 and holds a License No. 264671-1 (New York).

The current practice location address for Glen Steven Rudolph I is 3 Siwanoy Ln, Plattsburgh, NY and can be reached out via phone at 518-542-2276.

Location: 3 Siwanoy Ln, Plattsburgh, NY, 12901-6818
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386819571
Provider Name
Glen Steven Rudolph I
Credential
LPN
Provider Entity Type
Individual
Gender
Male
Address
3 Siwanoy Ln, Plattsburgh, NY, 12901-6818
Phone Number
518-542-2276
Fax Number
Provider Enumeration Date
04/28/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
02085918 05 NY
institution
Provider Business Practice Location Address Details
Address
3 Siwanoy Ln
City
Plattsburgh
State
New York
Zip
12901-6818
Phone Number
518-542-2276
Fax Number
person
Provider Business Mailing Address Details
Address
3 Siwanoy Ln
City
Plattsburgh
State
New York
Zip
12901-6818
Phone Number
518-542-2276
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
264671-1 (New York)
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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