Individual
MR. CHARLES EDWARD RICKARD JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MSN,APRN,BC
Contact information
Practice address
557 W PARK PL, HENDERSON, TN 38340-2027
(731) 989-1007
(731) 989-0704
Mailing address
9 PHYSICIANS DR, JACKSON, TN 38305-2071
(731) 989-1007
(731) 989-0704
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN0000006144
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0174180
BCBS
TN
05
—
3714672
—
TN
Enumeration date
01/16/2006
Last updated
03/15/2018
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