Individual
JESSICA LYNN ANDERSON-RIDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
28930 TRAILS EDGE BLVD, SUITE 200, BONITA SPRINGS, FL 34134-7518
(239) 293-0294
(239) 992-5785
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9283140
FL
363LF0000X
Family Nurse Practitioner
ARNP9283140
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009559000
—
FL
01
—
P01232801
RAILROAD MCR
FL
Enumeration date
11/19/2008
Last updated
12/20/2013
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