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

Miss. Mikala Riddlesworth, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1780718262

Miss. Mikala Riddlesworth, PHYSICIANASSISTANT is a Physician Assistant in Johnson City, Tennessee. Licensed in Georgia and Tennessee. Registered with an NPI since 2007.

Licensed in
GA, TN
In the registry since
2007
Specialties on file
3

Practice location Address checks out

2151 Century Ln
Johnson City, TN 37604-4469
Phone: (423) 926-2500
Fax: (423) 926-5999
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1858 (TN)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 004986 (GA)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1780718262
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedMarch 15, 2007
Last updated in NPPESJuly 8, 2016

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