Individual
NICOLE RICKABAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
310 13TH ST SE, APT 2, WASHINGTON, DC 20003-2268
(540) 931-6569
Mailing address
310 13TH ST SE, APT 2, WASHINGTON, DC 20003-2268
(540) 931-6569
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110-005726
VA
363A00000X
Physician Assistant
Primary
PA031345
DC
Other
Enumeration date
04/06/2017
Last updated
04/06/2017
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