Individual
MISS JANE A. RICKMAN
Active
Individual
MISS JANE A. RICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-152963
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209-001566
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00944335
RR MEDICARE
IL
Enumeration date
06/14/2005
Last updated
04/26/2017
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