Provider Demographics
NPI:1679747414
Name:RIDDELL, KATE (MD)
Entity type:Individual
Prefix:DR
First Name:KATE
Middle Name:
Last Name:RIDDELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:RICHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:77 SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:EAST KINGSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03827-2125
Mailing Address - Country:US
Mailing Address - Phone:603-772-5501
Mailing Address - Fax:
Practice Address - Street 1:8 PROSPECT ST DEPT OF
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3925
Practice Address - Country:US
Practice Address - Phone:603-577-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15937207LC0200X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine