Healthcare Provider Details

I. General information

NPI: 1407701386
Provider Name (Legal Business Name): KAYLA RICKERT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 MICHIGAN ST
SIDNEY OH
45365-2401
US

IV. Provider business mailing address

2987 SUMMER FIELD TRL
SIDNEY OH
45365-7363
US

V. Phone/Fax

Practice location:
  • Phone: 937-498-5391
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number426149
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number426149
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number426149
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: