Jared Ruddy

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Pfafftown, NC

NPI 1669348603 · NPPES record last updated Oct 16, 2025

Key facts

NPI
1669348603
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1480 Turfwood Dr
Pfafftown, NC 27040-9515
Phone
(717) 253-4984
NPI assigned
Oct 16, 2025
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NC Yes

Addresses

Primary practice location

1480 Turfwood Dr
Pfafftown, NC 27040-9515

Mailing address

1480 Turfwood Dr
Pfafftown, NC 27040-9515
Phone (717) 253-4984

Other providers in Pfafftown, NC

All providers in Pfafftown, NC · Student in an Organized Health Care Education/Training Program in North Carolina

Sources for this page

Verify at the official NPI Registry.