Individual
BARBARA RIDEOUT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Contact information
Practice address
850 N 11TH ST, PHILADELPHIA, PA 19123-1957
(215) 769-1100
(215) 769-1117
Mailing address
5843 WOODBINE AVE, PHILADELPHIA, PA 19131-1205
(215) 877-8257
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
TP004431C
PA
Other
Enumeration date
08/18/2005
Last updated
07/08/2007
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