Provider Demographics
NPI:1114678521
Name:RICKMAN, LUCY MEGGS (DNP)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:MEGGS
Last Name:RICKMAN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11803 SOUTH FWY STE 208
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7030
Mailing Address - Country:US
Mailing Address - Phone:817-551-9339
Mailing Address - Fax:817-551-3757
Practice Address - Street 1:11803 SOUTH FWY STE 208
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7030
Practice Address - Country:US
Practice Address - Phone:817-551-9339
Practice Address - Fax:817-551-3757
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1158603363LX0001X
AL1-181752163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse