Individual
AMY KATHLEEN RIDENOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 558-4194
(513) 558-0995
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5502
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
COA 06815 NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200490670
—
IN
05
—
2306909
—
OH
05
—
74008368
—
KY
Enumeration date
07/31/2006
Last updated
06/05/2017
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