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Individual
JANE RUDDEN
Active
Individual
JANE RUDDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, RN
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
031218
NY
163W00000X
Registered Nurse
Primary
636424-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00031218
—
NY
01
—
0004900287001
BSNENY
—
01
—
999652
MVP
—
Enumeration date
08/29/2006
Last updated
11/20/2014
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