Provider Demographics
NPI:1891298428
Name:MCKINNEY RIDGELL, WARRIE ANN
Entity Type:Individual
Prefix:
First Name:WARRIE
Middle Name:ANN
Last Name:MCKINNEY RIDGELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 COMMONS RD N
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-5417
Mailing Address - Country:US
Mailing Address - Phone:330-646-6343
Mailing Address - Fax:
Practice Address - Street 1:667 DICKEY AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-2738
Practice Address - Country:US
Practice Address - Phone:330-646-6343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-09
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide