Provider Demographics
NPI:1942826904
Name:RICCI, ANGEL RUBEN (APRN, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:RUBEN
Last Name:RICCI
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W HAGUE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5805
Mailing Address - Country:US
Mailing Address - Phone:915-491-7003
Mailing Address - Fax:915-751-7660
Practice Address - Street 1:125 W HAGUE RD STE 220
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5805
Practice Address - Country:US
Practice Address - Phone:915-745-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM60435363LF0000X
TX1000941363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily