Provider Demographics
NPI:1023193562
Name:BROWN, RIKKY ROCHELLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:RIKKY
Middle Name:ROCHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 H ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2817
Mailing Address - Country:US
Mailing Address - Phone:661-324-7208
Mailing Address - Fax:661-324-3403
Practice Address - Street 1:2525 H ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2817
Practice Address - Country:US
Practice Address - Phone:661-324-7208
Practice Address - Fax:661-324-3403
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17552363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical