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Individual

JULIE A RIDGLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
3400 DEXTER CT, SUITE 101, DAVENPORT, IA 52807-3461
(563) 344-6600
(563) 344-6699
Mailing address
3400 DEXTER CT, SUITE 101, DAVENPORT, IA 52807-3461
(563) 344-6600
(563) 344-6699

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D-086516
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0415471
IA
01
34796
BLUE CROSS BLUE SHIELD
IA
01
P00105711
RAILROAD MEDICARE
IA
Enumeration date
05/01/2006
Last updated
11/19/2013
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