Provider Demographics
NPI:1275956260
Name:RICKELMAN, ABBI NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:ABBI
Middle Name:NICOLE
Last Name:RICKELMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 NW 18TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-7846
Mailing Address - Country:US
Mailing Address - Phone:515-957-4042
Mailing Address - Fax:515-598-7855
Practice Address - Street 1:1210 NW 18TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-7846
Practice Address - Country:US
Practice Address - Phone:515-957-4042
Practice Address - Fax:515-598-7855
Is Sole Proprietor?:No
Enumeration Date:2014-01-27
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4451111N00000X
IA075794111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB3316002Medicare UPIN