AUDRA C RICICA

FORT WAYNE, IN
NPI1790769099
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: IN  28188589A)
Additional Taxonomies367500000X Nurse Anesthetist, Certified Registered
(Licence: OH  RN-252552)
Enumeration Date2005-12-01
Last Update Date2018-10-30
Business Address
AUDRA C RICICA CRNA
5050 N CLINTON ST
FORT WAYNE, IN 46825-5886
Phone number: 260-484-8551
Mailing Address
AUDRA C RICICA CRNA
5052 N CLINTON ST
FORT WAYNE, IN 46825-5822
Phone number: 260-484-8551