Healthcare Provider Details
I. General information
NPI: 1922002294
Provider Name (Legal Business Name): RITA H PICKLER RN, PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/02/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 E. LEIGH STREET BOX 980567
RICHMOND VA
23219
US
IV. Provider business mailing address
2403 E GRACE ST
RICHMOND VA
23223-7153
US
V. Phone/Fax
- Phone: 804-828-0721
- Fax: 804-828-7743
- Phone: 804-225-8884
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WG0000X |
| Taxonomy | General Practice Registered Nurse |
| License Number | 0001080840 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | 0024080840 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: