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Individual
STACY KIT RICKERD
Active
Individual
STACY KIT RICKERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
255641
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23355143
NCSBN
AZ
01
—
255641
AZ STATE BOARD OF NURSING
AZ
Enumeration date
09/26/2020
Last updated
02/21/2025
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