Individual
ADRIAN RICKETTS DAVIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1901 JUAN TABO BLVD NE, ALBUQUERQUE, NM 87112-3303
(505) 281-5180
(505) 702-8171
Mailing address
6419 BRISTOL HWY, PINEY FLATS, TN 37686-5208
(615) 202-3359
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1151615
TN
363A00000X
Physician Assistant
3603
TN
363A00000X
Physician Assistant
Primary
PA2026-0017
NM
363A00000X
Physician Assistant
TC954
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3603
STATE LICENSE
TN
05
—
7100690300
—
KY
05
—
Q045211
—
TN
01
—
TC954
STATE LICENSE
KY
Enumeration date
06/05/2018
Last updated
03/19/2026
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