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General NPI Number Information
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NPI Number | 1528941887
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Entity Type | Individual
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Provider Name | RICHARD CHIMA IKERI SR.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 425 LAURIE RD E
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City | MAPLEWOOD
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State | MN
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Zip | 55117-1840
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Country | US
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Telephone | 651-341-9099
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Fax | 651-340-9099
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Provider Business Mailing Address
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Address Line | 2703 SNOWDRIFT CIR E
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City | MAPLEWOOD
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State | MN
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Zip | 55119-5993
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Country | US
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Telephone | 651-341-9099
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Fax | 651-414-9102
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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