| NPI | 1114202504 |
|---|---|
| Former Name | STACEY A RIDDLEBERGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: NY 402391-1) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: NY 402391-1) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2023-05-09 |