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Individual

MARY S RICCELLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
10290 S PROGRESS WAY STE 208, PARKER, CO 80134-9056
(720) 317-9460
(877) 268-5001
Mailing address
488 PAWLING AVE, TROY, NY 12180-5832
(720) 317-9460
(877) 268-5001

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN0004954
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41929705
CO
Enumeration date
07/12/2006
Last updated
05/14/2021
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