Individual
JESSICA ERIN RULEN-RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2860 THIRD AVENUE, SUITE 210, HUNTINGTON, WV 25702-1453
(304) 526-7246
(304) 526-1951
Mailing address
2860 THIRD AVENUE, SUITE 210, HUNTINGTON, WV 25702-1453
(304) 526-7246
(304) 526-1951
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
01230
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001892682
MSBCBS
WV
01
—
1072150
BRICKSTREET INDIVIDUAL
WV
01
—
P00363169
RR MEDICARE
WV
Enumeration date
09/20/2006
Last updated
08/19/2014
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