Individual
SHAUNA MACKENZIE RICKERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
2317 DECLARATION DR, RALEIGH, NC 27615-5638
(336) 420-5970
Mailing address
501 20TH ST STE 606, KNOXVILLE, TN 37916-1863
(865) 331-2278
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
277884
NC
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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