Individual
MRS. VASHTINA G ELLISON-RUDDOCK
Active
Individual
MRS. VASHTINA G ELLISON-RUDDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN1002387
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R159793
CRNP-ADVANCED PRACTICE REGISTERED NURSE
MD
01
—
RN1002387
CRNP-ADVANCED PRACTICE REGISTERED NURSE
DC
Enumeration date
11/21/2011
Last updated
01/25/2018
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