Individual
MRS. STEPHANIE RICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
3458 NEELY RD, JOINT BASE MDL, NJ 08641-5312
(609) 754-9324
Mailing address
35 MEDICAL GROUP, UNIT 5024, APO, AP 96319-5024
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
844041
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/15/2012
Last updated
07/12/2018
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