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General NPI Number Information
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NPI Number | 1861147837
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Entity Type | Individual
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Provider Name | REBEKAH ELIZABETH RIDENOUR FNP
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Gender | Female
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 1 BARNES JEWISH HOSPITAL PLZ
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1003
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Country | US
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Telephone | 314-454-8134
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Fax |
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Provider Business Mailing Address
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Address Line | 1956 SONNY DR
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City | ARNOLD
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State | MO
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Zip | 63010-1233
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Country | US
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Telephone | 706-681-8213
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209024957
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2021026752
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License Number State | MO
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