Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kirstin Fudge

Individual provider Surgical Physician Assistant · NPI 1689567133

Kirstin Fudge is a Physician Assistant in Rockford, Illinois. Qualified in 2025, 1 year ago. Practices with Swedishamerican Hospital, a 387-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2025
Specialties on file
3

Practice location Address checks out

1401 E State St
Rockford, IL 61104-2315
Phone: (779) 696-4410
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Surgical Physician Assistant Taxonomy 363AS0400X
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1689567133
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 2, 2025
Last updated in NPPESJune 2, 2025
Certification dateJune 2, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Swedishamerican Hospital — 387 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Rockford