| Doctor Name: | JESSICA LYNN ANDERSON-RIDDELL |
| NPI Number: | 1073768990 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | ARNP9283140 |
| Business Practice Address: | 28930 Trails Edge Blvd Suite 200 Bonita Springs, FL - 341347518 |
| Business Phone Number: | 2392930294 |
| Business Fax Number: | 2399925785 |
| Mailing Address: | 2234 Colonial Blvd, Attn: Payer Contracting & Relations Dept. FORT MYERS |
| State: | FL |
| Postal Code: | 339071412 |
| Phone Number: | 2399317342 |
| Fax Number: | 2399317385 |
| NPI Enumeration Date: | 11/19/2008 |
| NPI Last Update Date: | 12/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ARNP9283140 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |