Individual
MARISA RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
18701 N 67TH AVE, GLENDALE, AZ 85308-7100
(623) 561-1000
Mailing address
1514 W BERRIDGE LN, PHOENIX, AZ 85015-2057
(480) 209-3175
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN181155
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
278016
AZ
Other
Enumeration date
03/12/2019
Last updated
04/08/2024
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