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NPI 1326641499

NPI 1326641499 : ASHLEY ANN RICKETTS DNP PMHNP-BC : LOUISVILLE, KY

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General NPI Number Information
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    NPI Number           |    1326641499
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    Entity Type          |    Individual 
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    Provider Name        |    ASHLEY ANN RICKETTS DNP PMHNP-BC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/19/2020
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    Last Update Date     |    08/28/2026
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Provider Practice Location Address
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    Address Line         |    2355 POPLAR LEVEL RD STE 405 
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40217-1389
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    Country              |    US
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    Telephone            |    502-636-7845
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    Fax                  |    502-636-8045
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Provider Business Mailing Address
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    Address Line         |    PO BOX 776347 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60677-6347
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    Country              |    US
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    Telephone            |    502-975-2213
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    Fax                  |    502-272-5339
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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        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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    License Number       |    3015479
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    License Number State |    KY
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Taxonomy #2
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    3015479
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    License Number State |    KY
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