Provider Demographics
NPI:1689931024
Name:RICKER, SHILEIGH ERIN (STNA)
Entity Type:Individual
Prefix:MS
First Name:SHILEIGH
Middle Name:ERIN
Last Name:RICKER
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 CIRCULAR ST
Mailing Address - Street 2:
Mailing Address - City:UPPER SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:43351-1513
Mailing Address - Country:US
Mailing Address - Phone:419-202-5424
Mailing Address - Fax:
Practice Address - Street 1:455 CIRCULAR ST
Practice Address - Street 2:
Practice Address - City:UPPER SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:43351-1513
Practice Address - Country:US
Practice Address - Phone:419-202-5424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401337311211376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide