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NPI Code Detail

MEDICARE: RYANE MERIDYTH RIDDLE APRN

MEDICARE: RYANE MERIDYTH RIDDLE 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
1363LG0600XGerontology Nurse Practitioner2007028742MO
2363LA2200XAdult Health Nurse Practitioner2007028742MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01045246OTHERMORAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952634297
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYANE MERIDYTH RIDDLE APRN
Provider Business Mailing Address
First Line : 8921 E 81ST ST
Second Line :
City : RAYTOWN
State : MO
Zip : 64138-1506
Country : US
Telephone Number : 913-205-9013
Fax Number : 913-674-5563
Provider Business Practice Location Address
First Line : 2790 CLAY EDWARDS DR STE 1250
Second Line :
City : NORTH KANSAS CITY
State : MO
Zip : 64116-3260
Country : US
Telephone Number : 816-421-3700
Fax Number : 816-421-1654
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2009
Last Update Date : 07/18/2012

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