Individual
KATELIN J. RIDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
222 N 192ND ST, ELKHORN, NE 68022-5363
(402) 390-4111
(402) 390-4115
Mailing address
8005 FARNAM DR STE 305, OMAHA, NE 68114-3426
(402) 390-4111
(402) 390-4115
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1767
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962839056
—
IA
05
—
47068731742
—
NE
05
—
47068731751
—
NE
Enumeration date
09/27/2013
Last updated
12/15/2023
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