Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 994381 | CO |
NPI | 1003072307 |
---|---|
Provider Name | Mrs. Amy Lynn Rickman |
First Address | Colorado Springs, CO 80910-3127 |
Second Address | Colorado Springs, CO 80910-3127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2008 |
Last Update Date | 23/06/2020 |