Individual
KISANDRA LEIGH RICKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1610 TAZEWELL ROAD SUITE 203, TAZEWELL, TN 37879-3648
(423) 259-3701
(866) 954-5783
Mailing address
PO BOX 15004, KNOXVILLE, TN 37901-5004
(865) 541-8895
(865) 633-4808
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
29250
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q087307
—
TN
Enumeration date
12/16/2018
Last updated
02/14/2025
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