Provider Demographics
NPI:1194786525
Name:RIDENOUR, NANCY A (APN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:RIDENOUR
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNM COLLEGE OF NURSING MSC 09 5350
Mailing Address - Street 2:1 UNIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-6284
Mailing Address - Fax:505-272-6270
Practice Address - Street 1:UNM COLLEGE OF NURSING MSC 09 5350
Practice Address - Street 2:1 UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-6284
Practice Address - Fax:505-272-6270
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01494363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
209000370OtherAPN
309001400OtherCONT SUBS
041-317062OtherRN
MR0807644OtherDEA