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Individual

MRS. AMY SUE RIDENOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, FNP-C

Contact information

Practice address
429 N DOUGLAS DR, REPUBLIC, MO 65738-9525
(417) 350-9327
Mailing address
429 N DOUGLAS DR, REPUBLIC, MO 65738-9525
(417) 350-9327

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2020016165
MO

Other

Enumeration date
07/14/2020
Last updated
07/14/2020
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