Provider Demographics
NPI:1154968915
Name:RICKER, VILLA
Entity type:Individual
Prefix:
First Name:VILLA
Middle Name:
Last Name:RICKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 NEW RD APT 1
Mailing Address - Street 2:
Mailing Address - City:STRAFFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03884-6628
Mailing Address - Country:US
Mailing Address - Phone:978-457-1355
Mailing Address - Fax:
Practice Address - Street 1:53 HARVEST RD
Practice Address - Street 2:
Practice Address - City:CHICHESTER
Practice Address - State:NH
Practice Address - Zip Code:03258-6545
Practice Address - Country:US
Practice Address - Phone:978-457-1355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-28
Last Update Date:2019-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide