Kelly R Ridge, PAC Valid NPI

Individual provider · Surgical Physician Assistant · Brockton, MA

NPI

1992789739

Type

Individual (Type 1)

Primary specialty

Surgical Physician Assistant (Physician Assistant)

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363AS0400X

License number

1104 (MA)

Sex

Female

Sole proprietor

No

Enumerated

2005-12-05

Last updated

2025-02-10