Ridenour, Gregory

Ridenour, Gregory is an individual health care provider with primary practice located at 7950 W Jefferson Blvd , Fort Wayne IN 46804-4140. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care, Physician Assistants & Advanced Practice Nursing Providers / Neonatal. Physician Assistants & Advanced Practice Nursing Providers / Neonatal is his primary health care specialty. Ridenour, Gregory can be contacted via phone (260) 435-7001.

Contact Information

Primary practice address
7950 W Jefferson Blvd Fort Wayne IN 46804-4140
Phone: (260) 435-7001
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 28194228A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care 363LN0005X RN.429014 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 71007790A Indiana

Profile Details

NPI number 1447708979
LBN Legal business name Ridenour, Gregory
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2016
Last updated Mar 28th, 2022 - about 4 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 1447708979 NPPES
Ohio MEDICAID 0265386

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