Individual
KRISTINE ALICE RICCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1801 N SENATE BLVD, INDIANAPOLIS, IN 46202-1228
(317) 962-2515
(317) 962-2500
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2023194370
NC
363LF0000X
Family Nurse Practitioner
Primary
71015646A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104430628
ANTHEM PTAN
IN
05
—
300097631
—
IN
Enumeration date
08/01/2024
Last updated
11/05/2024
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