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Individual

RICHARD EARL RICKLEY JR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
1060 GAFFNEY ROAD #7440, COMMANDER, USA-MEDDAC-AK, ATTN: MCUC-MMD-QM, FT. WAINWRIGHT, AK 99703-4845
(907) 353-5418
(907) 353-4845
Mailing address
1060 GAFFNEY ROAD #7440, COMMANDER, USA-MEDDAC-AK, ATTN: MCUC-MMD-QM, FT. WAINWRIGHT, AK 99703-4845
(907) 353-5418
(907) 353-4845

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
25011
AK
163W00000X
Registered Nurse
R150185
MD
163W00000X
Registered Nurse
RN527259L
PA

Other

Enumeration date
11/29/2005
Last updated
07/08/2007
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