Female

Katelin J. Ridder PA

Physician Assistant in Elkhorn, NE(View on Map)

Full Name

Katelin J. Ridder PA

NPI Number

1962839506

NPI Type

Individual Provider

Gender

Female

Enumeration Date

09/27/2013

Specialties

(Taxonomies)

Code

363A00000X

Primary Taxonomy

Yes

Licenses

State

Nebraska

License Number

1767

Contact
Information

Purpose

Mailing
Location

Address

8005 FARNAM DR STE 305
222 N 192ND ST

City

Omaha
Elkhorn

State

NE
NE

Postal Code

68114-3426
68022-5363

Country

US
US

Telephone Number

(402) 390-4111
(402) 390-4111

Identifiers

Identifier

1962839056
47068731751
47068731742

Identifier State

IA
NE
NE

Identifier Issuer

Unknown
Unknown
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/15/2023

Provider Address

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