Provider Demographics
NPI:1902150089
Name:ALDRIDGE, JOHN RYAN (CRNP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:RYAN
Last Name:ALDRIDGE
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 E SOUTH BLVD STE 601
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2014
Mailing Address - Country:US
Mailing Address - Phone:334-281-9000
Mailing Address - Fax:334-281-8262
Practice Address - Street 1:2055 E SOUTH BLVD STE 601
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2014
Practice Address - Country:US
Practice Address - Phone:334-281-9000
Practice Address - Fax:334-281-8262
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-102777363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care