Individual
KATHERINE LEE RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9880 ANGIES WAY STE 250, LOUISVILLE, KY 40241-2865
(502) 394-6341
(502) 394-6340
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2897
KY
363A00000X
Physician Assistant
TC150
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300057843
—
IN
05
—
7100785660
—
KY
Enumeration date
07/28/2021
Last updated
02/27/2026
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