| Doctor Name: | WENDY MCKAY RIDDLE |
| NPI Number: | 1679806251 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | 1052702 |
| Business Practice Address: | 34885 Hwy 43 Ste 2 Hackleburg, AL - 355640221 |
| Business Phone Number: | 2059353744 |
| Business Fax Number: | 2059353779 |
| Mailing Address: | Po Box 221, HACKLEBURG |
| State: | AL |
| Postal Code: | 355640221 |
| Phone Number: | 2059353744 |
| Fax Number: | 2059353779 |
| NPI Enumeration Date: | 09/14/2009 |
| NPI Last Update Date: | 09/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 1052702 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |