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| Type | Legal entity | [sources] | |||
|---|---|---|---|---|---|
| Name | Riddle, Angie C | [sources] | |||
| Legal form | not available | [sources] | |||
| Country | United States | [sources] | |||
| NPI | 1962745356 | [sources] | |||
| Sector | Nurse Practitioner | [sources] | |||
| Status | not available | [sources] | |||
| Address | 8350 US Highway 64 Bartlett, TN 38133-4130 | [sources] | |||
| Last change | Last processed | First seen | |||
Service providers who have been terminated for cause from Mississippi's Medicaid program.
United States of America · Mississippi Division of Medicaid
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