Individual
SUSAN PUDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
375 NW BEAVER ST, PRINEVILLE, OR 97754-1802
(541) 447-5165
Mailing address
7752 NW COUNTRY LOOP, PRINEVILLE, OR 97754-8137
(541) 447-1947
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
200140686RN
OR
Other
Enumeration date
11/03/2017
Last updated
11/03/2017
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