Individual
MRS. NATALIE N. RICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1107 MEMORIAL DR, SUITE 201, DALTON, GA 30720-8668
(706) 277-7311
(706) 272-3512
Mailing address
136 BATTLEFIELD CROSSING CT, RINGGOLD, GA 30736-5176
(706) 277-7311
(706) 529-7210
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3087
TN
363A00000X
Physician Assistant
PA.200490
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2167731
—
LA
01
—
5F600PF54
MEDICARE - PTAN
LA
Enumeration date
09/14/2011
Last updated
04/06/2021
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