Provider Demographics
NPI:1215548664
Name:RIDENOUR, ALLISON RENEE (FNP-C)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:RENEE
Last Name:RIDENOUR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 HOSPITAL WAY
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-2004
Mailing Address - Country:US
Mailing Address - Phone:412-664-3392
Mailing Address - Fax:
Practice Address - Street 1:500 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-2004
Practice Address - Country:US
Practice Address - Phone:412-664-3392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2022-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022145363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily