Individual
KELLY SHIVEL RUDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 SHIRCLIFF WAY, JACKSONVILLE, FL 32204-4748
(904) 308-7300
Mailing address
2165 HERSCHEL ST, JACKSONVILLE, FL 32204-3819
(904) 387-4030
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
9180092
FL
Other
Enumeration date
05/19/2013
Last updated
05/19/2013
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