Individual
DR. DEANNA N. RUDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16101 CANTRELL RD STE 104, LITTLE ROCK, AR 72223-4578
(501) 425-0322
Mailing address
16101 CANTRELL RD STE 104, LITTLE ROCK, AR 72223-4578
(501) 425-0322
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
N8430
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129401001
—
AR
Enumeration date
08/16/2005
Last updated
03/17/2018
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