Provider Demographics
NPI:1235189598
Name:RIDDLE, YVONNE (APRN, NNP)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:
Last Name:RIDDLE
Suffix:
Gender:F
Credentials:APRN, NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3408 RODDY DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-2066
Mailing Address - Country:US
Mailing Address - Phone:817-905-3829
Mailing Address - Fax:
Practice Address - Street 1:1301 PENNSYLVANIA AVE
Practice Address - Street 2:NEONATOLOGY OFFICE
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2122
Practice Address - Country:US
Practice Address - Phone:817-250-2892
Practice Address - Fax:817-250-5335
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX520285363LN0005X
TXAP107731363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care