Individual
RIDLEY THERESA LOREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2725 S 144TH ST STE 212, OMAHA, NE 68144-5253
(402) 609-3000
(402) 609-3808
Mailing address
2725 S 144TH ST STE 212, OMAHA, NE 68144-5253
(402) 609-3000
(402) 609-3808
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
130521
IA
363A00000X
Physician Assistant
Primary
3216
NE
Other
Enumeration date
06/27/2023
Last updated
02/26/2025
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