Individual
MARIAH RIDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7453 AVALON TRAIL RD, INDIANAPOLIS, IN 46250-2817
(317) 572-7065
Mailing address
7453 AVALON TRAIL RD, INDIANAPOLIS, IN 46250-2817
(317) 748-4739
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28245518A
IN
Other
Enumeration date
09/28/2024
Last updated
09/28/2024
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