Doctor Name: | SHELLEY P RICKETT |
NPI Number: | 1437510807 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | NUR-APRN-LIC-102257 |
Business Practice Address: | 10110 South 7650 East Box 9 Crow Agency, MT - 590220009 |
Business Phone Number: | 4066383500 |
Business Fax Number: | |
Mailing Address: | 438 Sarpy Creek Rd, HYSHAM |
State: | MT |
Postal Code: | 590389613 |
Phone Number: | 4065819119 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2016 |
NPI Last Update Date: | 03/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | NUR-APRN-LIC-102257 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |