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Individual

SURONDA RICKETTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN BSN CCE

Contact information

Practice address
1203 MAPLE ST, GREENSBORO, NC 27405-6910
(336) 362-6064
Mailing address
1203 MAPLE ST, GREENSBORO, NC 27405-6910
(336) 362-6064

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
138084
NC

Other

Enumeration date
01/11/2019
Last updated
01/11/2019
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