Individual
ANNETT JACKSON RICKETTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1024 BAY 30TH ST FL 1, FAR ROCKAWAY, NY 11691-1842
(347) 339-9016
Mailing address
1024 BAY 30TH ST FL 1, FAR ROCKAWAY, NY 11691-1842
(347) 339-9016
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304647
NY
Other
Enumeration date
08/16/2011
Last updated
02/26/2015
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