Provider Demographics
NPI:1780624429
Name:RICKARD, ANN SCOTT (NP-C)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:SCOTT
Last Name:RICKARD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13641 TURLEYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BROADWAY
Mailing Address - State:VA
Mailing Address - Zip Code:22815-2506
Mailing Address - Country:US
Mailing Address - Phone:540-896-3709
Mailing Address - Fax:
Practice Address - Street 1:1414 N AUGUSTA ST
Practice Address - Street 2:POB 2126
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-2126
Practice Address - Country:US
Practice Address - Phone:540-332-7830
Practice Address - Fax:540-885-0149
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024110381363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAS99280Medicare UPIN