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Individual
MRS. REBECCA LAUREN RIDENOUR
Active
Individual
MRS. REBECCA LAUREN RIDENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71008204A
IN
363LA2100X
Acute Care Nurse Practitioner
71008204A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28216997A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
05/21/2018
Last updated
09/29/2025
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