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Individual

KRISTEN ANN RICKERTSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
213 EAST KIMBALL STREET, CALLAWAY, NE 68825-2596
(308) 836-2294
(308) 836-2451
Mailing address
213 EAST KIMBALL STREET, CALLAWAY, NE 68825-2596
(308) 836-2294
(308) 836-2451

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
111241
NE
363LF0000X
Family Nurse Practitioner
96801
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200258850A
OK
Enumeration date
09/01/2009
Last updated
07/13/2011
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