Individual
BRIAN RIDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 STATE ST, ERIE, PA 16550-0002
(814) 877-2938
Mailing address
5538 E LAKE RD, ERIE, PA 16511-1438
(417) 291-9957
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN725132
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN725132
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN725132
PA RN LICENSE
PA
Enumeration date
07/02/2021
Last updated
05/12/2023
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