Individual
BARBARA LEE RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
22395 EDGEWATER DR, PORT CHARLOTTE, FL 33980-2012
(941) 766-7222
(941) 766-0970
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 274-8200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11005371
FL
363LG0600X
Gerontology Nurse Practitioner
APRN11005371
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113840200
—
FL
Enumeration date
04/23/2020
Last updated
05/02/2022
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