Davies, Adrian Ricketts

Davies, Adrian Ricketts is an sole proprietor health care provider with primary practice located at 550 Sunset Trl , Jellico TN 37762-2343. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Davies, Adrian Ricketts can be contacted via phone (615) 202-3359.

Contact Information

Primary practice address
550 Sunset Trl Jellico TN 37762-2343
Phone: (615) 202-3359
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X TC954 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1151615 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3603 Tennessee

Profile Details

NPI number 1366934382
LBN Legal business name Davies, Adrian Ricketts
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 5th, 2018
Last updated May 10th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366934382 NPPES
Kentucky Other TC954 STATE LICENSE
Kentucky MEDICAID Q045211 STATE LICENSE
Kentucky Other 3603 STATE LICENSE
Kentucky MEDICAID 7100690300 STATE LICENSE

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