Provider Demographics
NPI:1073945150
Name:RYDER, CAROLINE (NNP-BC)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:RYDER
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:KAYOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2838 FREMONT AVE S
Mailing Address - Street 2:UNIT 247
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2086
Mailing Address - Country:US
Mailing Address - Phone:952-200-9840
Mailing Address - Fax:
Practice Address - Street 1:225 E CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2991
Practice Address - Country:US
Practice Address - Phone:312-227-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN632363LN0000X
IL209.027303363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal