Individual
STACIE LYNN RICKETTS-MCCOOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1133 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5085
(678) 604-5901
Mailing address
863 N MAIN STREET EXT STE 200, WALLINGFORD, CT 06492-2434
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
10235
CT
363LA2200X
Adult Health Nurse Practitioner
Primary
RN185141
GA
Other
Enumeration date
11/13/2019
Last updated
07/19/2024
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