# JILL ANN RIDGE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1417040049
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 31003075A | IN | Yes |
| 225XH1200X | Hand Occupational Therapist | 31003075A | IN | — |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 04/01/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000185049 | ANTHEM HEALTH PLAN | — |
| 01 | — | 062110023 | MEDICARE PTAN | IN |
| 05 | — | 200250070 | — | IN |
| 01 | — | P00708373 | RR MEDICARE | IN |