Individual
JEFFREY THOMAS RIORDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
405 OWEN DR, FAYETTEVILLE, NC 28304
(910) 323-3183
Mailing address
405 OWEN DR, FAYETTEVILLE, NC 28304-3411
(984) 234-2369
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5010625
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215996103
—
NC
Enumeration date
06/20/2018
Last updated
06/26/2018
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