Ridenoure, Jennifer

Ridenoure, Jennifer is an individual health care provider with primary practice located at 1330 Riverland Rd , Fort Lauderdale FL 33312-2961. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Ridenoure, Jennifer can be contacted via phone (954) 321-9826.

Contact Information

Primary practice address
1330 Riverland Rd Fort Lauderdale FL 33312-2961
Phone: (954) 321-9826
Fax: (954) 321-9660
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9103460 Florida

Profile Details

NPI number 1912012816
LBN Legal business name Ridenoure, Jennifer
Credentials P.A.C
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2006
Last updated Jul 8th, 2007 - about 17 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 1912012816 NPPES
Florida MEDICAID 292299100

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