Ricketts, Charlene Alicia

Ricketts, Charlene Alicia is an individual health care provider with primary practice located at 10301 Hagen Ranch Rd Ste B200 , Boynton Beach FL 33437-3723. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Ricketts, Charlene Alicia can be contacted via phone (561) 752-9490.

Contact Information

Primary practice address
10301 Hagen Ranch Rd Ste B200 Boynton Beach FL 33437-3723
Phone: (561) 752-9490
Fax: (561) 752-9491
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 11018494 Florida

Profile Details

NPI number 1598413221
LBN Legal business name Ricketts, Charlene Alicia
Credentials PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 11th, 2022
Last updated Jan 15th, 2024 - about 2 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 1598413221 NPPES
Florida MEDICAID 113751100

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