Provider Demographics
NPI:1902504483
Name:RIDEOUT, MICHELE M (RN)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:M
Last Name:RIDEOUT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 DOWNING RD
Mailing Address - Street 2:
Mailing Address - City:ARUNDEL
Mailing Address - State:ME
Mailing Address - Zip Code:04046-8533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:136 DOWNING RD
Practice Address - Street 2:
Practice Address - City:ARUNDEL
Practice Address - State:ME
Practice Address - Zip Code:04046-8533
Practice Address - Country:US
Practice Address - Phone:774-289-1666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN67818163WH0200X, 163WH1000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice