Provider Demographics
NPI:1376583948
Name:RIDGLEY, JANET LEEE (WHCNP/FNP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LEEE
Last Name:RIDGLEY
Suffix:
Gender:F
Credentials:WHCNP/FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:FOSSIL
Mailing Address - State:OR
Mailing Address - Zip Code:97830
Mailing Address - Country:US
Mailing Address - Phone:541-763-2725
Mailing Address - Fax:541-763-2850
Practice Address - Street 1:712 JAY ST
Practice Address - Street 2:
Practice Address - City:FOSSIL
Practice Address - State:OR
Practice Address - Zip Code:97830
Practice Address - Country:US
Practice Address - Phone:541-763-2725
Practice Address - Fax:541-763-2850
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily