Audra C Ricica, CRNA
Nurse Anesthetist, Certified Registered in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1790769099
StatusActive
Last updated in NPPESOct 30, 2018
Details
- NPI
- 1790769099
- Entity type
- Individual (NPI-1)
- Name
- Audra C Ricica
- Credential
- CRNA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 1, 2005
- Last updated
- Oct 30, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 28188589A | IN | Yes |
| 367500000X | Nurse Anesthetist, Certified Registered | RN-252552 | OH |
Practice location
5050 N Clinton StFort Wayne, IN 46825-5886
Phone 260-484-8551 · Fax 260-482-5060
Mailing address
5052 N Clinton StFort Wayne, IN 46825-5822
Phone 260-484-8551 · Fax 260-482-5060
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