Individual
CRYSTAL RIDENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, PMHNP-BC
Contact information
Practice address
1015 MICHIGAN AVE, LOGANSPORT, IN 46947-1526
(574) 722-5151
(574) 739-1414
Mailing address
1015 MICHIGAN AVE, LOGANSPORT, IN 46947-1526
(574) 722-5151
(574) 739-1414
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71004557A
IN
Other
Enumeration date
12/09/2013
Last updated
05/01/2019
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