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General NPI Number Information
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NPI Number | 1275094039
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Entity Type | Individual
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Provider Name | EMMA RICKLES
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Gender | Female
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 10085 DOUBLE R BLVD STE 205
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City | RENO
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State | NV
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Zip | 89521-3854
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Country | US
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Telephone | 775-982-2280
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Fax | 775-982-7205
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Provider Business Mailing Address
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Address Line | 1155 MILL ST MS M-14
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City | RENO
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State | NV
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Zip | 89502-1576
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Country | US
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Telephone | 775-982-5262
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Fax | 775-982-2973
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 68259
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 25396
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License Number State | NV
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