Healthcare Provider Details

I. General information

NPI: 1861237281
Provider Name (Legal Business Name): MICHAELA RICKER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 LINDEN DR STE 152
WINCHESTER VA
22601-2893
US

IV. Provider business mailing address

135 W LUCKY ESTATES DR
HARRINGTON DE
19952-2471
US

V. Phone/Fax

Practice location:
  • Phone: 540-667-0744
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: