Individual
JUDITH H RICKETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7320
(757) 668-9735
Mailing address
PO BOX 79137, BALTIMORE, MD 21279-0137
(757) 668-7200
(757) 668-9691
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024166418
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010170443
—
VA
05
—
8052308
—
NC
Enumeration date
07/05/2006
Last updated
01/20/2010
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