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Individual

MRS. STACIE MARIE RICKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
1265 NEW GERMANY RD, SUMMERHILL, PA 15958-5301
(814) 244-2939
Mailing address
1020 FRANKLIN STREET, JOHNSTOWN, PA 15905-4109
(814) 534-9230

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
RN547989
PA
367A00000X
Advanced Practice Midwife
Primary
MW010546
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
N/A
Enumeration date
05/14/2019
Last updated
04/14/2022
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