Provider Demographics
NPI:1477681674
Name:RARICK, BRUCE ALLAN (CRNFA)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:ALLAN
Last Name:RARICK
Suffix:
Gender:M
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 WHISPERING WINDS LN
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-4032
Mailing Address - Country:US
Mailing Address - Phone:530-894-6416
Mailing Address - Fax:530-894-6416
Practice Address - Street 1:702 WHISPERING WINDS LN.
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928
Practice Address - Country:US
Practice Address - Phone:530-894-6416
Practice Address - Fax:530-894-6416
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA445287163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant