Provider Demographics
NPI:1487989661
Name:RICKS, STARLA C (APN)
Entity type:Individual
Prefix:
First Name:STARLA
Middle Name:C
Last Name:RICKS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 12TH ST
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-4002
Mailing Address - Country:US
Mailing Address - Phone:775-299-0066
Mailing Address - Fax:866-493-4019
Practice Address - Street 1:160 12TH ST
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-4002
Practice Address - Country:US
Practice Address - Phone:775-372-7444
Practice Address - Fax:866-493-4019
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001153363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVAPN001153OtherAPN LICENSE #