Individual
NICOLA RICKETTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1147 CHARMING PINES PL NE, CONYERS, GA 30012-5223
(718) 518-9007
Mailing address
1147 CHARMING PINES PL NE, CONYERS, GA 30012-5223
(718) 518-9007
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
578272-1
NY
363LA2200X
Adult Health Nurse Practitioner
GAA-NP004259
GA
363LA2200X
Adult Health Nurse Practitioner
Primary
NP712978
GA
Other
Enumeration date
05/16/2012
Last updated
03/17/2026
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