Provider Demographics
NPI:1609185362
Name:BURROUGHS, RIKKA M (ARNP)
Entity Type:Individual
Prefix:
First Name:RIKKA
Middle Name:M
Last Name:BURROUGHS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:RIKKA
Other - Middle Name:M
Other - Last Name:KNOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 3178
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52406-3178
Mailing Address - Country:US
Mailing Address - Phone:319-398-1583
Mailing Address - Fax:319-399-2085
Practice Address - Street 1:202 10TH STREET SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2404
Practice Address - Country:US
Practice Address - Phone:319-247-3010
Practice Address - Fax:319-399-2036
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA114305363L00000X
IAH114305363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner