Healthcare Provider Details

I. General information

NPI: 1992133623
Provider Name (Legal Business Name): BONNIE ANNETTE RICKENBACH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2013
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2271 QUAIL RD
CHAPMAN KS
67431-9339
US

IV. Provider business mailing address

2271 QUAIL RD
CHAPMAN KS
67431-9339
US

V. Phone/Fax

Practice location:
  • Phone: 605-890-0634
  • Fax:
Mailing address:
  • Phone: 605-890-0634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-78629-031
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: