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NPI Code Detail

MEDICARE: CODY WESTON RICKER APRN, FNP-C

MEDICARE: CODY WESTON RICKER APRN, FNP-C
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
1363LF0000XFamily Nurse Practitioner3016757KY
2363LF0000XFamily Nurse Practitioner40148TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13016757OTHERKYKBN APRN

General Provider Information

NPI Number : 1730842170
Entity Type Code : Individual
Provider Name (Legal Business Name) : CODY WESTON RICKER APRN, FNP-C
Provider Business Mailing Address
First Line : 5200 COMMERCE CROSSINGS DR
Second Line : FL 3
City : LOUISVILLE
State : KY
Zip : 40229-2182
Country : US
Telephone Number : 502-253-4924
Fax Number : 502-489-5750
Provider Business Practice Location Address
First Line : 1940 ALCOA HWY STE E310
Second Line :
City : KNOXVILLE
State : TN
Zip : 37920-2267
Country : US
Telephone Number : 865-544-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2021
Last Update Date : 01/13/2026

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