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Individual

HOLLY RIDGLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
670 INDIAN TRL RD NW, LILBURN, GA 30047-1716
(770) 925-0088
Mailing address
2287 MITFORD CT, DACULA, GA 30019-2494
(229) 507-9216

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN202171
GA

Other

Enumeration date
01/24/2014
Last updated
01/24/2014
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