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Individual

MICHELE A RIDDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1306 STATE ST, AUGUSTA, KS 67010-1126
(316) 775-9191
(316) 775-0348
Mailing address
1306 STATE ST, AUGUSTA, KS 67010-1126
(316) 775-9191
(316) 775-0348

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44523
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100422080C
KS
Enumeration date
08/20/2006
Last updated
07/09/2007
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