Individual
BARBARA RUDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1209 WOODROW AVE, STE B-10, MODESTO, CA 95350
(209) 558-5312
Mailing address
830 SCENIC DR, SUITE B, MODESTO, CA 95350-6131
(209) 558-7000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP6855
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN164803
MEDICAL
CA
Enumeration date
04/11/2006
Last updated
07/08/2007
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