Provider Demographics
NPI:1902798408
Name:RIDOUT, ADRIEN
Entity type:Individual
Prefix:
First Name:ADRIEN
Middle Name:
Last Name:RIDOUT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14461 HIGHWAY 157
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:LA
Mailing Address - Zip Code:71006-4429
Mailing Address - Country:US
Mailing Address - Phone:318-517-2311
Mailing Address - Fax:
Practice Address - Street 1:201 GRAY ST
Practice Address - Street 2:
Practice Address - City:BELCHER
Practice Address - State:LA
Practice Address - Zip Code:71004-7729
Practice Address - Country:US
Practice Address - Phone:903-947-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA241668363LP2300X, 364S00000X, 364SF0001X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health