Jennifer Criddle, RN – Registered Nurse

Key facts

NPI: 1366239246
Entity type: Individual (NPI type 1)
Primary specialty: Registered Nurse 163W00000X
License: 28151408A (IN)
Practice address: 101 N Michigan St
Plymouth, IN 46563-2132
Phone: (574) 360-7467
NPI assigned: Apr 23, 2025
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Registered Nurse

State licenses

License	State	Type	Specialty
28151408A	IN	MD	Registered Nurse

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Registered Nurse	163W00000X	28151408A	IN	Yes

Addresses

Primary practice location

101 N Michigan St
Plymouth, IN 46563-2132

Mailing address

101 N Michigan St
Plymouth, IN 46563-2132
Phone (574) 360-7467

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 23, 2025.

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1366239246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N MICHIGAN ST",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465632132",
            "telephone_number": "574-360-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N MICHIGAN ST",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465632132",
            "telephone_number": "574-360-7467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIDDLE",
        "first_name": "JENNIFER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28151408A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, IN

All providers in Plymouth, IN · Registered Nurse in Indiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.