Provider Demographics
NPI:1558120899
Name:RIDGLEY, JENNIFER JARVELA (PA, ASCP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JARVELA
Last Name:RIDGLEY
Suffix:
Gender:F
Credentials:PA, ASCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4216 HARDY AVE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-4709
Mailing Address - Country:US
Mailing Address - Phone:678-592-7670
Mailing Address - Fax:
Practice Address - Street 1:4216 HARDY AVE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-4709
Practice Address - Country:US
Practice Address - Phone:678-592-7670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology