Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 23635 | CA |
NPI | 1013339761 |
---|---|
Provider Name | Mrs. Amber Hardy Rickner |
First Address | Hayward, CA 94544-6885 |
Second Address | Hayward, CA 94544-6885 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2014 |
Last Update Date | 15/01/2014 |