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MR. GLEN STEVEN RUDOLPH I LPN
NPI 1386819571
Licensed Practical Nurse in Plattsburgh, NY

Active since April 28, 2008
3 SIWANOY LN, PLATTSBURGH, NY 12901(518) 542-2276 Get Directions Write a Review

NPPES record last updated: April 28, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Glen Steven Rudolph I Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. GLEN STEVEN RUDOLPH I LPN (NPI 1386819571) is an individual licensed practical nurse in Plattsburgh, New York, licensed in New York (264671-1) and active in the NPI registry since April 2008.

NPPES Registry Identity

NPI1386819571
Entity TypeIndividualMale
Primary Taxonomy164W00000X
Provider Legal NameMR. GLEN STEVEN RUDOLPH ICredential: LPN
Location Address3 SIWANOY LNPlattsburgh, NY 12901-6818
Mailing Address3 Siwanoy LnPlattsburgh, NY 12901-6818 · (518) 542-2276
Phone(518) 542-2276
Sole ProprietorYes
Enumeration DateApril 28, 2008
✔ NPI 1386819571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in NY · 264671-1
Definition
A licensed practical nurse 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.
3 SIWANOY LN, Plattsburgh, NY 12901
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Other Identifiers 1

Medicaid02085918NY

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glen Rudolph's NPI number?

The NPI number for Glen Rudolph is 1386819571. It was assigned to this individual provider in the NPPES registry on April 28, 2008.

Where is Glen Rudolph located?

Glen Rudolph practices at 3 Siwanoy Ln, Plattsburgh, NY 12901. The listed phone number is (518) 542-2276.

What is Glen Rudolph's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Glen Rudolph was last updated on April 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.