Individual
MARY M RIDDETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
7938 STRATFORD LN, ATLANTA, GA 30350-4159
(770) 804-9479
Mailing address
7938 STRATFORD LN, ATLANTA, GA 30350-4159
(770) 804-9479
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN061255
GA
Other
Enumeration date
11/26/2012
Last updated
11/26/2012
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