MISS MIKALA RIDDLESWORTH PHYSICIAN ASSISTANT
NPI 1780718262
Physician Assistant in Johnson City, TN

Q: What is Mikala Riddlesworth's NPI number?

The NPI number for Mikala Riddlesworth is 1780718262. It was assigned to this individual provider in the NPPES registry on March 15, 2007.

Q: What is Mikala Riddlesworth's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since March 15, 2007

2151 CENTURY LN, JOHNSON CITY, TN 37604(423) 926-2500(423) 926-5999 Get Directions Write a Review

NPPES record last updated: July 8, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Miss Mikala Riddlesworth Physician Assistant NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS MIKALA RIDDLESWORTH PHYSICIAN ASSISTANT (NPI 1780718262) is an individual physician assistant in Johnson City, Tennessee, licensed in Tennessee (1858) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1780718262

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMISS MIKALA RIDDLESWORTHCredential: PHYSICIAN ASSISTANT

Location Address2151 CENTURY LNJohnson City, TN 37604-4469

Mailing Address365 Stout Drive Box 70403Johnson City, TN 37614-1703 · (423) 439-4515 · Fax (423) 439-4060

Phone(423) 926-2500

Fax(423) 926-5999

Sole ProprietorNo

Enumeration DateMarch 15, 2007

Last NPPES UpdateJuly 8, 2016

✔ NPI 1780718262 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in TN · 1858

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 004986 (GA)

2151 CENTURY LN, Johnson City, TN 37604

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Other Identifiers 1

Medicare PIN103I973910

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. REBECCA ELLEN FLORA-WATERMAN APRN, FNP

Nurse Practitioner (Primary Care)