Provider Demographics
NPI:1013686732
Name:RICO-ECCLES, BARBARA ADELFA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ADELFA
Last Name:RICO-ECCLES
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 NAYLOR HALL
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-5488
Mailing Address - Country:US
Mailing Address - Phone:678-994-1453
Mailing Address - Fax:
Practice Address - Street 1:2611 NAYLOR HALL
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-5488
Practice Address - Country:US
Practice Address - Phone:678-994-1453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA296387163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health