Individual
KERRI RUDDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
502 E AMENDE DR, ODESSA, WA 99159-7003
(509) 982-2611
Mailing address
3665 W EVERGREEN DR, COEUR D ALENE, ID 83815-9018
(208) 790-5191
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
61858
ID
363LF0000X
Family Nurse Practitioner
Primary
AP61469089
WA
363LF0000X
Family Nurse Practitioner
NP61858
ID
Other
Enumeration date
06/18/2019
Last updated
09/23/2025
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