Individual
MRS. TAMI LYNN RICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4700 PUDDLEDOCK ROAD, SUITE 300, PRINCE GEORGE, VA 23875-1268
(804) 526-1111
(804) 526-8363
Mailing address
4700 PUDDLEDOCK ROAD, SUITE 300, PRINCE GEORGE, VA 23875-1268
(804) 526-1111
(804) 526-8363
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024165943
VA
363LW0102X
Women's Health Nurse Practitioner
0024165943
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005641276
—
VA
Enumeration date
07/21/2006
Last updated
07/27/2015
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