Individual
DR. KELLY M RUDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D., BCPS
Contact information
Practice address
1111 W 17TH ST, TULSA, OK 74107-1886
(185) 618-2399
Mailing address
34794 S HIGHWAY 82, VINITA, OK 74301-7045
(315) 717-3268
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19454
OK
183500000X
Pharmacist
19713
IA
1835P1200X
Pharmacotherapy Pharmacist
050193
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19434
OKLAHOMA STATE BOARD OF PHARMACY
OK
Enumeration date
12/15/2005
Last updated
04/17/2025
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