Individual
MRS. LAUREN ALDERDICE RIDGWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2405 HARRODSBURG RD, LEXINGTON, KY 40504-3329
(859) 278-9492
(859) 469-5461
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1169
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0169
LC MEDICARE GROUP ID
KY
01
—
95900478
LC MEDICAID GROUP ID PA NUMBER
KY
Enumeration date
12/16/2008
Last updated
10/10/2024
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