Individual
MS. JANET P. RUDDERHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
311 W LINCOLN ST STE 101, BELLEVILLE, IL 62220-1902
(618) 222-3200
(618) 222-3203
Mailing address
311 W LINCOLN ST STE 101, BELLEVILLE, IL 62220-1902
(618) 222-3200
(618) 222-3203
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085003452
IL
Other
Enumeration date
10/31/2005
Last updated
09/12/2018
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