Healthcare Provider Details

I. General information

NPI: 1811854912
Provider Name (Legal Business Name): AMANDA R RICKLEFS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 4TH ST
BURT IA
50522-7709
US

IV. Provider business mailing address

704 WALNUT ST
BURT IA
50522-5023
US

V. Phone/Fax

Practice location:
  • Phone: 646-694-2836
  • Fax:
Mailing address:
  • Phone: 608-718-4808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number166902
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number166902
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: