Provider Demographics
NPI:1932685633
Name:RIDENOUR, KRIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:
Last Name:RIDENOUR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 TOWNE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LEECHBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15656-9420
Mailing Address - Country:US
Mailing Address - Phone:724-845-1077
Mailing Address - Fax:
Practice Address - Street 1:41 TOWNE CENTER DR
Practice Address - Street 2:
Practice Address - City:LEECHBURG
Practice Address - State:PA
Practice Address - Zip Code:15656-9420
Practice Address - Country:US
Practice Address - Phone:724-845-1077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042607L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist