Individual
KATHERINE RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
15750 NORTHLINE RD, SOUTHGATE, MI 48195-2378
(734) 357-0505
(734) 357-0506
Mailing address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 205-4800
(517) 205-1713
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704318916
MI
Other
Enumeration date
08/15/2023
Last updated
08/04/2025
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