Provider Demographics
NPI:1427553908
Name:SUTTON, RIDDHI P (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:RIDDHI
Middle Name:P
Last Name:SUTTON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:RIDDHI
Other - Middle Name:P
Other - Last Name:SUTTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:700 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-2457
Mailing Address - Country:US
Mailing Address - Phone:256-262-6707
Mailing Address - Fax:
Practice Address - Street 1:700 W MARKET ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2457
Practice Address - Country:US
Practice Address - Phone:256-262-6707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2017037596363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology