| Doctor Name: | ELIZABETH A RIDDLE |
| NPI Number: | 1720075633 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CFNP |
| License Number: | 10751 |
| Business Practice Address: | 136 S Wilson St Dresden, TN - 382251133 |
| Business Phone Number: | 7313527907 |
| Business Fax Number: | 7313644900 |
| Mailing Address: | 205 Hospital Dr, Suite A MC KENZIE |
| State: | TN |
| Postal Code: | 382011649 |
| Phone Number: | 7313527907 |
| Fax Number: | 7313524459 |
| NPI Enumeration Date: | 10/05/2005 |
| NPI Last Update Date: | 07/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 10751 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |