Individual
MRS. STACEY RICKETTS-KIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1510 WATERS PL, BRONX, NY 10461-2700
(347) 493-8503
Mailing address
1510 WATERS PL, BRONX, NY 10461-2700
(347) 493-8503
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
596177-1
NY
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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