Provider Demographics
NPI:1346214095
Name:RICKRICH, SAUNDRA (LPN)
Entity Type:Individual
Prefix:
First Name:SAUNDRA
Middle Name:
Last Name:RICKRICH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 NORFOLK CT
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-2066
Mailing Address - Country:US
Mailing Address - Phone:614-837-1718
Mailing Address - Fax:
Practice Address - Street 1:616 NORFOLK CT
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-2066
Practice Address - Country:US
Practice Address - Phone:614-837-1718
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN100292164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2143513OtherOHIO INDEPENDENT PROVIDER