Healthcare Provider Details

I. General information

NPI: 1033205281
Provider Name (Legal Business Name): KAREN LYNN RIDENOUR FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN SUNNY HOBBS ARNP-BC

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 N STONE AVE
TUCSON AZ
85705-4503
US

IV. Provider business mailing address

2828 N STONE AVE
TUCSON AZ
85705-4503
US

V. Phone/Fax

Practice location:
  • Phone: 520-245-6650
  • Fax:
Mailing address:
  • Phone: 520-245-6650
  • Fax: 480-776-0025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN00099474
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN128384
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30005175
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number000-00-4767
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number66740254405
License Number StateUT
# 6
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP1993
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: