Individual
MS. LISA PAULA RUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1132 N CHURCH ST STE 200, GREENSBORO, NC 27401-1040
(336) 379-9445
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-1331
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5016456
NC
363LF0000X
Family Nurse Practitioner
5016456
NC
Other
Enumeration date
06/30/2022
Last updated
03/11/2024
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