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General NPI Number Information
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NPI Number | 1821383670
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Entity Type | Organization
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Legal Business Name | ROBERSON RIKE CLINIC
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 08/21/2012
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Provider Practice Location Address
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Address Line | 768 EVERETT ST.
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City | TIPTONVILLE
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State | TN
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Zip | 38079
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Country | US
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Telephone | 731-253-3760
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Fax |
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Provider Business Mailing Address
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Address Line | 768 EVERETT ST.
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City | TIPTONVILLE
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State | TN
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Zip | 38079
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Country | US
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Telephone | 731-253-3760
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DONNA RIKE
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Credential | FNP
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Telephone | 731-253-3760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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