Individual
GUY H. J. RUDDICK
Active
Individual
GUY H. J. RUDDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2000161005
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
426004305
—
MO
01
—
82290
AR BLUE SHIELD #
MO
Enumeration date
02/06/2007
Last updated
07/22/2008
Update your record
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