Healthcare Provider Details

I. General information

NPI: 1740032853
Provider Name (Legal Business Name): RYKER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 N 44TH ST APT 4401
PHOENIX AZ
85008-3256
US

IV. Provider business mailing address

2121 N 44TH ST APT 4401
PHOENIX AZ
85008-3256
US

V. Phone/Fax

Practice location:
  • Phone: 218-491-1110
  • Fax:
Mailing address:
  • Phone: 218-491-1110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: REHEMA BAILIE
Title or Position: CEO
Credential: BSN, RN
Phone: 218-491-1110