Individual
STINA JENNIFER RUDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1090 5TH ST SE, CAIRO, GA 39828-3139
(229) 377-1100
Mailing address
900 CAIRO RD, THOMASVILLE, GA 31792-4255
(229) 227-5158
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006097
GA
Other
Enumeration date
05/16/2011
Last updated
06/25/2015
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