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Individual

RICKEY D ALBAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.N., C.R.N.A.

Contact information

Practice address
3045 S NATIONAL AVE, SUITE 100, SPRINGFIELD, MO 65804-4247
(417) 882-1900
(417) 882-1966
Mailing address
3045 S NATIONAL AVE, SUITE 100, SPRINGFIELD, MO 65804-4247
(417) 882-1900
(417) 882-1966

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
058813
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
058813
STATE LICENSE
MO
Enumeration date
12/27/2005
Last updated
11/26/2007
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