| Doctor Name: | RICKEY I TABOR |
| NPI Number: | 1245267251 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | R15408 |
| Business Practice Address: | 1600 North Main Lovington, NM - 882602813 |
| Business Phone Number: | 5753963529 |
| Business Fax Number: | 5753961454 |
| Mailing Address: | 1600 North Main, LOVINGTON |
| State: | NM |
| Postal Code: | 882602813 |
| Phone Number: | 5753963529 |
| Fax Number: | 5753961454 |
| NPI Enumeration Date: | 06/26/2006 |
| NPI Last Update Date: | 04/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R15408 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |