Individual
JEANIE VICKNAIR RICARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2215 VETERANS MEMORIAL BLVD, METAIRIE, LA 70002-6322
(504) 838-3524
(504) 828-6155
Mailing address
1805 MASON SMITH AVE, METAIRIE, LA 70003-5017
(504) 655-3145
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN106424
LA
363L00000X
Nurse Practitioner
AP06894
LA
363LF0000X
Family Nurse Practitioner
Primary
AP06894
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2302337
—
LA
Enumeration date
06/29/2012
Last updated
10/18/2019
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