Individual
MRS. MARYBETH ANDREA RUDISILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
4437 INNSBRUCK RDG, MEDFORD, OR 97504-9058
(541) 227-3180
Mailing address
4437 INNSBRUCK RDG, MEDFORD, OR 97504-9058
(541) 227-3180
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200842425RN
OR
163WM0102X
Maternal Newborn Registered Nurse
200842425RN
OR
Other
Enumeration date
11/20/2009
Last updated
11/20/2009
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