Provider Demographics
NPI:1083867527
Name:RIDDLE, CYNTHIA K (STNA)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:K
Last Name:RIDDLE
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13515 LIMNWORTHY DR
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8315
Mailing Address - Country:US
Mailing Address - Phone:740-927-7764
Mailing Address - Fax:740-927-7764
Practice Address - Street 1:13515 LIMNWORTHY DR
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-8315
Practice Address - Country:US
Practice Address - Phone:740-927-7764
Practice Address - Fax:740-927-7764
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400823121008376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide