Provider Demographics
NPI:1861157422
Name:RICKS, DEANN MICHELLE (APRN)
Entity type:Individual
Prefix:
First Name:DEANN
Middle Name:MICHELLE
Last Name:RICKS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DEANN
Other - Middle Name:MICHELLE
Other - Last Name:RIFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 511360
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-7915
Mailing Address - Country:US
Mailing Address - Phone:510-929-9075
Mailing Address - Fax:510-929-1414
Practice Address - Street 1:6880 S MCCARRAN BLVD STE 5
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6129
Practice Address - Country:US
Practice Address - Phone:775-398-1981
Practice Address - Fax:775-398-1984
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV847118363LA2200X, 363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology