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Individual

MERJURIE FAIR RICKLEFS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP, PMHNP-BC

Contact information

Practice address
3670 S 25TH E STE 4, IDAHO FALLS, ID 83404-4956
(208) 821-0357
Mailing address
3670 S 25TH E STE 4, IDAHO FALLS, ID 83404-4956
(208) 821-0357

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
66558
ID

Other

Enumeration date
12/03/2020
Last updated
04/14/2021
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