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Individual

ELIZABETH A RIDDLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
136 S WILSON ST, DRESDEN, TN 38225-1133
(731) 352-7907
(731) 364-4900
Mailing address
205 HOSPITAL DR, SUITE A, MC KENZIE, TN 38201-1649
(731) 352-7907
(731) 352-4459

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10751
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1512644
TN
01
3380640
MEDICARE GROUP
TN
Enumeration date
10/05/2005
Last updated
10/05/2022
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