Provider Demographics
NPI:1083399018
Name:RUDD, MELISSA FELICE (MA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:FELICE
Last Name:RUDD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-3637
Mailing Address - Country:US
Mailing Address - Phone:419-740-3052
Mailing Address - Fax:419-893-0475
Practice Address - Street 1:2211 RIVER RD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-3637
Practice Address - Country:US
Practice Address - Phone:419-740-3052
Practice Address - Fax:419-893-0475
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program