Individual
JESSICA RICAURTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-7203
Mailing address
605 IDLEWILD CIR APT 201, BIRMINGHAM, AL 35205-5822
(205) 569-3784
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
11540839-4405
UT
Other
Enumeration date
11/12/2019
Last updated
12/03/2019
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