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General NPI Number Information
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NPI Number | 1952634297
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Entity Type | Individual
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Provider Name | RYANE MERIDYTH RIDDLE APRN
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Gender | Female
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Dates
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Enumeration Date | 09/17/2009
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 2790 CLAY EDWARDS DR STE 1250
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-3260
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Country | US
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Telephone | 816-421-3700
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Fax | 816-421-1654
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Provider Business Mailing Address
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Address Line | 8921 E 81ST ST
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City | RAYTOWN
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State | MO
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Zip | 64138-1506
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Country | US
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Telephone | 913-205-9013
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Fax | 913-674-5563
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 2007028742
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 2007028742
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License Number State | MO
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