Provider Demographics
NPI:1306631528
Name:RIDLER, KATIE LOUISE (PA-S)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:LOUISE
Last Name:RIDLER
Suffix:
Gender:F
Credentials:PA-S
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3114 BAVARIA HILLS TRL
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-2723
Mailing Address - Country:US
Mailing Address - Phone:952-210-0274
Mailing Address - Fax:
Practice Address - Street 1:2 PINE TREE DR
Practice Address - Street 2:
Practice Address - City:ARDEN HILLS
Practice Address - State:MN
Practice Address - Zip Code:55112-3754
Practice Address - Country:US
Practice Address - Phone:651-638-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant