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Individual

TERRY RIDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
13450 N MERIDIAN ST STE 354, CARMEL, IN 46032-1486
(317) 249-0990
Mailing address
13450 N MERIDIAN ST STE 354, CARMEL, IN 46032-1486

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71000193
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71000193A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200208340
IN
Enumeration date
10/04/2006
Last updated
08/10/2022
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