Individual
TATYANA EASTLYN JACK RUDDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, ARNP
Contact information
Practice address
1625 SE 3RD AVE STE 502, FT LAUDERDALE, FL 33316-2521
(954) 581-8706
Mailing address
7331 NW 35TH ST, LAUDERHILL, FL 33319-4913
(954) 529-1607
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
9314525
FL
Other
Enumeration date
03/02/2018
Last updated
03/02/2018
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