Ricks, Kizzie

Ricks, Kizzie is an individual health care provider with primary practice located at 516 E Nizhoni Blvd , Gallup NM 87301-5748. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Ricks, Kizzie can be contacted via phone (505) 722-1000.

Contact Information

Primary practice address
516 E Nizhoni Blvd Gallup NM 87301-5748
Fax: (505) 722-1771
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X AP60721673 Washington

Profile Details

NPI number 1780123430
LBN Legal business name Ricks, Kizzie
Credentials MSN, CNM, ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2017
Last updated Feb 14th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780123430 NPPES
New Mexico MEDICAID MR4156596

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