Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2015-00330 | NC |
Y | 208600000X | Surgeon | 2015-00330 | NC |
N | 208200000X | Surgeon | LL32642 | SC |
N | 208600000X | Surgeon | LL32642 | SC |
N | 2086S0129X | Vascular Surgeon | 2015-00330 | NC |
NPI | 1063732634 |
---|---|
Provider Name | Ashley Kaiser Rickey |
First Address | Charlotte, NC 28260-0447 |
Second Address | Winston Salem, NC 27103-4145 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2010 |
Last Update Date | 25/10/2020 |