Individual
MRS. KELLY MARIE RUDROFF
Active
Individual
MRS. KELLY MARIE RUDROFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
900243
MS
363LF0000X
Family Nurse Practitioner
Primary
2016042952
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609216159
UNSURE OF ISSUER
MO
Enumeration date
06/28/2013
Last updated
04/14/2018
Update your record
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