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NPI Code Detail

MEDICARE: RACHEL RIDLEY APRN

MEDICARE: RACHEL RIDLEY APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse9339164FL
2363LF0000XFamily Nurse PractitionerAP70019380WA
3363LF0000XFamily Nurse PractitionerAPRN11040620FL

General Provider Information

NPI Number : 1639897242
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL RIDLEY APRN
Provider Business Mailing Address
First Line : 2508 7TH ST SE
Second Line :
City : PUYALLUP
State : WA
Zip : 98374-1105
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2508 7TH ST SE
Second Line :
City : PUYALLUP
State : WA
Zip : 98374-1105
Country : US
Telephone Number : 253-841-6600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2022
Last Update Date : 03/17/2026

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Directions to “ RACHEL RIDLEY APRN” Practice Location

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