Individual
KIM T. RICKETSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3825 LAMONT ST, RICHMOND, VA 23227-4049
(804) 262-6141
Mailing address
3825 LAMONT ST, RICHMOND, VA 23227-4049
(804) 262-6141
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024094136
VA
Other
Enumeration date
06/13/2006
Last updated
06/16/2010
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