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NPI Code Detail

MEDICARE: DARRYL DARWIN RICKER JR.

MEDICARE: DARRYL DARWIN RICKER JR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1417813668
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARRYL DARWIN RICKER JR.
Provider Business Mailing Address
First Line : 3322 STRAHAN PKWY
Second Line :
City : SHERIDAN
State : WY
Zip : 82801-9162
Country : US
Telephone Number : 307-672-2044
Fax Number : 307-674-6867
Provider Business Practice Location Address
First Line : 3322 STRAHAN PKWY
Second Line :
City : SHERIDAN
State : WY
Zip : 82801-9162
Country : US
Telephone Number : 307-672-2044
Fax Number : 307-674-6867
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2025
Last Update Date : 01/05/2026

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