Individual
BEVERLY J RICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5300 MEMORIAL DR, TWO RIVERS, WI 54241
(429) 075-9853
Mailing address
5300 MEMORIAL DR, TWO RIVERS, WI 54241-3923
(429) 075-9853
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
33359
WI
208000000X
Pediatrics Physician
9937
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108971
UCARE #
ND
01
—
1203226
MEDICA #
ND
01
—
1203227
MEDICA #
ND
01
—
1203228
MEDICA #
ND
01
—
1203229
MEDICA #
ND
05
—
13381
—
ND
01
—
24202
AMERICA'S PPO/ARAZ #
ND
01
—
25404
NDBS #
ND
01
—
25406
NDBS #
ND
05
—
32019300
—
WI
01
—
40858
LHS/BANNERHEALTH #
ND
05
—
647218400
—
ND
01
—
972S0RI
MNBS #
ND
01
—
972S1RI
MNBS #
ND
01
—
972S2RI
MNBS #
ND
01
—
972S3RI
MNBS #
ND
01
—
DA9061008851
PREFERRED ONE #
ND
Enumeration date
05/22/2006
Last updated
05/14/2020
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