Individual
ELISABETH ROSE MUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 HAIRPIN DRIVE, EDWARDSVILLE, IL 62026-0001
(618) 650-3956
Mailing address
1 HAIRPIN DRIVE, EDWARDSVILLE, IL 62026-0001
(618) 650-3956
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
39
IL
Other
Enumeration date
05/07/2026
Last updated
05/07/2026
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