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NPI Code Detail

MEDICARE: DR. KATHLEEN B RICKARD DNP, FNP-C

MEDICARE: DR. KATHLEEN B RICKARD DNP, 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
1363L00000XNurse PractitionerRN046461AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922003250
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN B RICKARD DNP, FNP-C
Provider Business Mailing Address
First Line : 11209 N TATUM BLVD STE 160
Second Line :
City : PHOENIX
State : AZ
Zip : 85028-3092
Country : US
Telephone Number : 480-285-2180
Fax Number : 480-285-2182
Provider Business Practice Location Address
First Line : 11209 N TATUM BLVD STE 160
Second Line :
City : PHOENIX
State : AZ
Zip : 85028-3092
Country : US
Telephone Number : 480-285-2180
Fax Number : 480-285-2182
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 07/14/2022

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