Provider Demographics
NPI:1295415453
Name:ROSS, BRIKKI NICOLE (RN)
Entity type:Individual
Prefix:MISS
First Name:BRIKKI
Middle Name:NICOLE
Last Name:ROSS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:BRIKKI
Other - Middle Name:
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BRIKKI ROSS
Mailing Address - Street 1:96 TOMMY STALNAKER DR STE A
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-9236
Mailing Address - Country:US
Mailing Address - Phone:478-333-2735
Mailing Address - Fax:478-845-7390
Practice Address - Street 1:96A TOMMY STALNAKER DR # R
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-9179
Practice Address - Country:US
Practice Address - Phone:478-333-2735
Practice Address - Fax:478-845-7390
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN322397163W00000X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty