Individual
JASON RYAN RIDENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
5160 E SOUTHPORT RD, INDIANAPOLIS, IN 46237-9601
(317) 672-2773
Mailing address
675 S 100 W, FRANKLIN, IN 46131-8432
(317) 919-7650
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71017046A
IN
Other
Enumeration date
09/05/2025
Last updated
09/05/2025
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