Provider Demographics
NPI:1184878415
Name:RYDELL, ASHLEY LYNN
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:LYNN
Last Name:RYDELL
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 1:9732 CO RD 22
Mailing Address - Street 2:
Mailing Address - City:FAIRMOUNT
Mailing Address - State:ND
Mailing Address - Zip Code:58030
Mailing Address - Country:US
Mailing Address - Phone:701-640-3407
Mailing Address - Fax:
Practice Address - Street 1:106 4TH AVE N
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-1034
Practice Address - Country:US
Practice Address - Phone:218-998-3778
Practice Address - Fax:218-998-3187
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNL067170-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse