Doctor Name: | SARA DIANN RIDLEN |
NPI Number: | 1083968309 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 71004243A |
Business Practice Address: | 1466 W Oak St Zionsville, IN - 460771800 |
Business Phone Number: | 3178736438 |
Business Fax Number: | |
Mailing Address: | 851 Golfview Dr, Apt. H CARMEL |
State: | IN |
Postal Code: | 460324866 |
Phone Number: | 3172468198 |
Fax Number: | |
NPI Enumeration Date: | 11/08/2012 |
NPI Last Update Date: | 11/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 71004243A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |