Provider Demographics
NPI:1558540518
Name:RIDENHOUR, AMANDA LEIGH (MSN, MED, RD, NP-C)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:LEIGH
Last Name:RIDENHOUR
Suffix:
Gender:F
Credentials:MSN, MED, RD, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 DUKE MEDICINE CIR # 1A
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-3000
Mailing Address - Country:US
Mailing Address - Phone:919-668-5360
Mailing Address - Fax:919-684-5743
Practice Address - Street 1:30 DUKE MEDICINE CIR # 1A
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-3000
Practice Address - Country:US
Practice Address - Phone:919-668-5360
Practice Address - Fax:919-684-5743
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD002434133V00000X
NCL002333133V00000X
NC292466163WD0400X
NC5014253363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator