Healthcare Provider Details

I. General information

NPI: 1629986948
Provider Name (Legal Business Name): JANICE RIDDLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8882 E PENSTEMON DR
TUCSON AZ
85715-5926
US

IV. Provider business mailing address

8882 E PENSTEMON DR
TUCSON AZ
85715-5926
US

V. Phone/Fax

Practice location:
  • Phone: 813-956-8200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: