Individual
GAYE SUZETTE RIDDICK-BURDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
833 CHESTNUT ST, SUITE 204, PHILADELPHIA, PA 19107-4414
(215) 955-8153
Mailing address
833 CHESTNUT ST. SUITE 701, PHILADELPHIA, PA 19107-3308
(215) 955-0207
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
TP006928C
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103161142
—
PA
Enumeration date
03/28/2012
Last updated
06/03/2019
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