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General NPI Number Information
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NPI Number | 1184950792
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Entity Type | Individual
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Provider Name | JILL A. RIDLEY NP
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Gender | Female
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Dates
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Enumeration Date | 11/02/2009
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 159 SNOWSHOE CIRCLE
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City | BRECKENRIDGE
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State | CO
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Zip | 80424
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Country | US
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Telephone | 720-256-8709
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Fax | 970-668-0632
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Provider Business Mailing Address
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Address Line | P.O. BOX 1864
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City | FRISCO
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State | CO
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Zip | 80443
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Country | US
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Telephone | 720-256-8709
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Fax | 970-945-5523
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 178705
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10142
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 10142
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1266
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License Number State | CO
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