Provider Demographics
NPI:1255593208
Name:LEDRIDGE, TONI ARLENE (RN)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:ARLENE
Last Name:LEDRIDGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10303 S D ST
Mailing Address - Street 2:
Mailing Address - City:ISLAND CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97850-9486
Mailing Address - Country:US
Mailing Address - Phone:541-910-0458
Mailing Address - Fax:
Practice Address - Street 1:10303 S D ST
Practice Address - Street 2:
Practice Address - City:ISLAND CITY
Practice Address - State:OR
Practice Address - Zip Code:97850-9486
Practice Address - Country:US
Practice Address - Phone:541-910-0458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR084058385RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health