Riddle, Jentry Danielle

Riddle, Jentry Danielle is an individual health care provider with primary practice located at 4204 East Stan Schleuter Loop , Killeen TX 76542-8352. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Riddle, Jentry Danielle can be contacted via phone (254) 690-2800.

Contact Information

Primary practice address
4204 East Stan Schleuter Loop Killeen TX 76542-8352
Phone: (254) 690-2800
Fax: (254) 690-5401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X MP00154600 New Jersey
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA05748 Texas
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA05748 Texas

Profile Details

NPI number 1003849837
LBN Legal business name Riddle, Jentry Danielle
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Jun 15th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003849837 NPPES
Texas MEDICAID 1991747-01
Texas MEDICAID 1991747-02

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