Individual
ELLEN RICCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
95 SPRINGER RD, FREEDOM, PA 15042-2187
(724) 333-7034
Mailing address
95 SPRINGER RD, FREEDOM, PA 15042-2187
(724) 333-7034
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN568111
PA
363LF0000X
Family Nurse Practitioner
Primary
SP015226
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN568111
RN LICENSE
PA
01
—
SP015226
CRNP STATE LICENSE
PA
Enumeration date
07/23/2015
Last updated
08/23/2017
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