Provider Demographics
NPI:1861734675
Name:RIDER, MICHELE E (TECHNICIAN)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:E
Last Name:RIDER
Suffix:
Gender:F
Credentials:TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 DELNA DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-1406
Mailing Address - Country:US
Mailing Address - Phone:775-835-3355
Mailing Address - Fax:
Practice Address - Street 1:1715 KUENZLI ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1117
Practice Address - Country:US
Practice Address - Phone:775-334-0907
Practice Address - Fax:775-334-4356
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information