COURTNEY NICOLE RIDDLE APRN NPI 1114470549

NPI Information

NPI: 1114470549
Provider Name: COURTNEY NICOLE RIDDLE, APRN
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
104 HOSPITAL DRIVE
MAGNOLIA, AR
ZIP 71753
Phone: (870) 235-3555
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Courtney Nicole Riddle, APRN is an adult health nurse practitioner in Magnolia, AR with 8 years of experience. Courtney Nicole Riddle, APRN NPI is 1114470549. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

104 HOSPITAL DRIVE
MAGNOLIA, AR
ZIP 71753
Phone: (870) 235-3555

The NPI 1114470549 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/2/2016 and was last updated on 8/26/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		RN131227	LOUISIANA	No
2	163W00000X	Registered Nurse		R086552	ARKANSAS	No
3	363LA2200X	Nurse Practitioner	Adult Health	A004849	ARKANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	215626758	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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