Individual
MRS. JANE ALLISON RIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1451 HARBOR ISLAND DR, PORT ISABEL, TX 78578-2526
(956) 943-1752
(956) 943-1752
Mailing address
1451 HARBOR ISLAND DR, PORT ISABEL, TX 78578-2526
(956) 943-1752
(956) 943-1752
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
21518
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C39B
MEDICARE/BLUE CROSS
TX
01
—
21518
NATIONAL AANA CERTIFICATION
TX
01
—
3372
CALIFORNIA CRNA LICENSE
CA
01
—
427137
TEXAS LICENSE
TX
01
—
678888
CALIFORNIA RN LICENSE
CA
Enumeration date
04/23/2008
Last updated
04/23/2008
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