Individual
DR. AMANDA RUDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1511 CHRISTY DR, JEFFERSON CITY, MO 65101-2854
(573) 606-6924
Mailing address
1511 CHRISTY DR, JEFFERSON CITY, MO 65101-2854
(573) 606-6924
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2009020976
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2009020976
PHARMACIST LICENSE NUMBER
MO
Enumeration date
09/25/2011
Last updated
02/05/2024
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