Provider Demographics
NPI:1225005390
Name:RIDGWAY, ONA LUCIA (NP)
Entity type:Individual
Prefix:
First Name:ONA
Middle Name:LUCIA
Last Name:RIDGWAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-2916
Mailing Address - Country:US
Mailing Address - Phone:970-579-0003
Mailing Address - Fax:970-433-7671
Practice Address - Street 1:2140 N 12TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2916
Practice Address - Country:US
Practice Address - Phone:970-579-0003
Practice Address - Fax:970-433-7671
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0004533-NP363LF0000X, 363L00000X
CO99981363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO43689264Medicaid
CO43689264Medicaid
CO1225005390Medicare PIN