Individual
JASON BENGE RUDDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
38 LAKESIDE DR, LONDON, KY 40741-8323
(606) 309-9025
Mailing address
38 LAKESIDE DR, LONDON, KY 40741-8323
(606) 309-9025
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1112975
KY
163W00000X
Registered Nurse
RN212261
GA
246ZC0007X
Surgical Assistant
1112975
KY
Other
Enumeration date
11/19/2010
Last updated
04/08/2026
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