Individual
CRYSTAL RUDDELL MEREDITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
187 NINTH STREET, JENA, LA 71342
(318) 992-9296
(318) 992-9125
Mailing address
187 NINTH STREET, P.O. BOX 2780, JENA, LA 71342-2780
(318) 992-9200
(318) 992-9245
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.200237
LA
Other
Enumeration date
10/08/2008
Last updated
10/14/2009
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