Provider Demographics
NPI:1063984755
Name:RICKS, AUBREY MARIE (WHNP)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:MARIE
Last Name:RICKS
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:MARIE
Other - Last Name:SARGEANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3777 PEACHTREE RD NE APT 1612
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3399
Mailing Address - Country:US
Mailing Address - Phone:908-763-0431
Mailing Address - Fax:
Practice Address - Street 1:3777 PEACHTREE RD NE APT 1612
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-3399
Practice Address - Country:US
Practice Address - Phone:908-763-0431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN237890363L00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner