Healthcare Provider Details

I. General information

NPI: 1720510126
Provider Name (Legal Business Name): LINDSEY REED RICCI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY ELISE REED

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13001 E 17TH PL
AURORA CO
80045-2570
US

IV. Provider business mailing address

150 PIONEER LN
BISHOP CA
93514-2556
US

V. Phone/Fax

Practice location:
  • Phone: 720-777-3846
  • Fax:
Mailing address:
  • Phone: 760-873-6373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number169513
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: