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Individual

MS. CHARISSA ANNE DOUGLAS-RUDDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC, ARNP

Contact information

Practice address
4300 ALTON RD, MIAMI BEACH, FL 33140-2948
(305) 674-2200
Mailing address
10747 S PRESERVE WAY APT 202, MIRAMAR, FL 33025-6558
(917) 913-6860

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN9303889
FL
363LF0000X
Family Nurse Practitioner
Primary
ARNP9303889
FL

Other

Enumeration date
03/09/2018
Last updated
03/09/2018
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