Provider Demographics
NPI:1760822308
Name:WHITE RICKETTS, KENYA DANIELLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KENYA
Middle Name:DANIELLE
Last Name:WHITE RICKETTS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KENYA
Other - Middle Name:DANIELLE
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:805 CRANBERRY DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1112
Mailing Address - Country:US
Mailing Address - Phone:412-675-3119
Mailing Address - Fax:
Practice Address - Street 1:1305 FIFTH AVE
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-2424
Practice Address - Country:US
Practice Address - Phone:412-675-3119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN610282163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse