Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Idris Riddick, LPN

Individual provider Licensed Practical Nurse · NPI 1528543204

Idris Riddick, LPN is a Licensed Practical Nurse in Philadelphia, Pennsylvania. Practices as a sole proprietor. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2018
What do these letters mean?
LPN — Licensed Practical Nurse
A licensed nurse who works under the direction of an RN or physician.

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Practice location Address checks out

3872 Wyalusing Ave
Philadelphia, PA 19104-1124
Phone: (610) 679-1723
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence PN308356 (PA)

Record details

NPI number1528543204
Entity typeIndividual (Type 1)
GenderMale
Credentials LPN
Sole proprietorYes
NPI enumeratedSeptember 28, 2018
Last updated in NPPESSeptember 28, 2018

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