Provider Demographics
NPI:1700842200
Name:RICKETTS, KARENE J (MD)
Entity Type:Individual
Prefix:
First Name:KARENE
Middle Name:J
Last Name:RICKETTS
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 271647
Mailing Address - Street 2:UNC FP
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-1647
Mailing Address - Country:US
Mailing Address - Phone:919-966-5136
Mailing Address - Fax:984-974-4873
Practice Address - Street 1:DEPARTMENT OF ANESTHESIOLOGY
Practice Address - Street 2:N2198 UNC HOSPITALS, CB# 7010
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7010
Practice Address - Country:US
Practice Address - Phone:919-966-5136
Practice Address - Fax:984-974-4873
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2016-10-06
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Provider Licenses
StateLicense IDTaxonomies
WI48552207L00000X
NC2009-01025207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology