Provider Demographics
NPI:1871282137
Name:RYDOSZ, LEE ANN (APRN)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:ANN
Last Name:RYDOSZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 DUNWOODY SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4556
Mailing Address - Country:US
Mailing Address - Phone:630-269-0839
Mailing Address - Fax:
Practice Address - Street 1:993F JOHNSON FERRY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1602
Practice Address - Country:US
Practice Address - Phone:404-256-1727
Practice Address - Fax:404-256-3591
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN274180363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily