Individual
ALEXIS RYAN RICCIONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
40 OKATIE CENTER BLVD S STE 100, OKATIE, SC 29909-7519
(843) 705-9145
Mailing address
PO BOX 37643, BELFAST, ME 04915-1218
(843) 682-7480
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
30208
SC
363LF0000X
Family Nurse Practitioner
SP024245
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103912787
—
PA
01
—
15171368
CAQH
—
Enumeration date
08/16/2021
Last updated
08/15/2025
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