Individual
LORI A RICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2165 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-2707
(651) 523-9800
(651) 523-9801
Mailing address
2165 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-2707
(651) 523-9800
(651) 523-9801
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37047
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-00495
MEDICA
MN
01
—
108565
UCARE
MN
01
—
556K3RI
BCBS
MN
05
—
599022000
—
MN
01
—
HP11308
HEALTH PARTNERS
MN
01
—
NA9021018887
PREFERRED ONE
MN
Enumeration date
03/27/2006
Last updated
09/21/2020
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