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JEFFREY DEAN RIDGE FNP-C

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1083180533

Individual Registrant:
 JEFFREY DEAN RIDGE FNP-C
Gender: M
Not Sole Proprietor

Location and contact information for practice:
116 W MINNESOTA AVENUE  MCCLOUD, CA 96057 US
Tel: 530-964-2389  Fax: 530-964-3141

Contact information for business:
116 W MINNESOTA AVENUE  MCCLOUD, CA 96057 US
Tel: 530-964-2389  Fax: 530-964-3141

Registration Information:
NPI: 1083180533
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
CA95011517
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
TXAP139196

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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