Individual
MRS. CAROLYN RICKETTS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RDCS, RDMS, RVT, ARR
Contact information
Practice address
9022 LUCKY RD, MC MINNVILLE, TN 37110-4486
(931) 934-2020
(931) 934-2026
Mailing address
9022 LUCKY RD, MC MINNVILLE, TN 37110-4486
(931) 934-2020
(931) 934-2026
Taxonomy
Speciality
Code
Description
License number
State
246XS1301X
Sonography Specialist/Technologist Cardiovascular
10577
TN
2471C3402X
Radiography Radiologic Technologist
079866
TN
2471S1302X
Sonography Radiologic Technologist
10577
TN
2471V0105X
Vascular Sonography Radiologic Technologist
Primary
10577
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3790225
—
TN
01
—
4017629
BLUE CROSS BLUE SHIELD
TN
Enumeration date
06/13/2006
Last updated
09/11/2025
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