Provider Demographics
NPI:1689279960
Name:RIDER, ERIKA L (CRNP)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:L
Last Name:RIDER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-5530
Mailing Address - Country:US
Mailing Address - Phone:724-709-0726
Mailing Address - Fax:
Practice Address - Street 1:305 SEVENTH ST
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6529
Practice Address - Country:US
Practice Address - Phone:724-339-3900
Practice Address - Fax:724-339-3750
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022839363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily