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

Individual provider Acute Care Nurse Practitioner · NPI 1922696244

Mr. Shane Michael Rudolph, CRNP is an Acute Care Nurse Practitioner in Philadelphia, Pennsylvania. Practices as a sole proprietor and works from 2 locations. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2021
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

10833 Knights Rd
Philadelphia, PA 19154-4207
Phone: (215) 519-7279
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 60 Township Line Rd, Elkins Park, PA 19027-2220 — (215) 519-7279

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence SP023007 (PA)

Record details

NPI number1922696244
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNP
Sole proprietorYes
NPI enumeratedJanuary 3, 2021
Last updated in NPPESJanuary 3, 2021
Certification dateDecember 13, 2020

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